CMS Price Transparency Data

CT scan, sinuses

Facility: Carle Eureka Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $900
Cash Discount Price: $2,236
vs. Medicare Baseline: 8.43x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Carle Eureka Hospital is $900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,236. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.43x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$2,236

Average discount available for prompt cash payment at this facility.

Insurance Median

$900

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $2,236 (2093%)

Insurance Median: $900 (843%)

Cash: $2,236 (2093% of Medicare)

Ins. Median: $900 (843% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 843% of the Medicare baseline (a markup of 743%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$76 - $2,041	71%
Wellcare	$112	105%
Humana	$135 - $1,390	126%
Meridian	$138 - $1,482	129%
Molina	$277 - $1,482	259%
Cigna	$600	562%
UnitedHealthcare	$623 - $1,700	583%
Community Partners Health Plan (Cphp)	$830 - $1,853	777%
Healthlink	$900 - $2,007	843%
Blue Cross Blue Shield	$927 - $2,594	868%
Multiplan/Phcs	$1,038 - $2,316	972%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,236.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Carle Eureka Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.