CMS Price Transparency Data

CT scan, sinuses

Facility: Jacksonville Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,168
Cash Discount Price: $3,678
vs. Medicare Baseline: 20.30x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Jacksonville Memorial Hospital is $2,168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,678. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.30x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$3,678

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,168

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: $3,678 (3443%)

Insurance Median: $2,168 (2030%)

Cash: $3,678 (3443% of Medicare)

Ins. Median: $2,168 (2030% 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 2030% of the Medicare baseline (a markup of 1930%). 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
Blue Cross Blue Shield	$112 - $3,742	105%
Tricare	$118 - $682	110%
Coventry	$119 - $589	111%
Health Alliance	$119 - $2,545	111%
Humana	$119 - $3,192	111%
Medicare (plans)	$119 - $589	111%
UnitedHealthcare	$125 - $2,694	117%
Medicaid / KanCare	$209	196%
Molina Healthcare	$209	196%
Corvel/Corcare	$874 - $1,046	818%
Illinois Workers Compensation	$939 - $1,023	879%
Commercial Workers Compensation	$972	910%
Healthlink	$1,050 - $3,181	983%
Health Alliance Mh Employee Plan	$1,662 - $1,721	1556%
Current Health Network	$1,987 - $2,806	1860%
6 Degrees Health	$2,168 - $2,245	2030%
Hope Trust	$2,168 - $2,245	2030%
Hst	$2,168 - $2,245	2030%
Cigna	$2,504 - $2,593	2344%
Aetna	$2,525 - $2,994	2364%
Phcs/Multiplan	$3,252 - $3,368	3045%
Hfn	$3,432 - $3,555	3213%
Liability	$3,613 - $3,742	3383%

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 $3,678.
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 Jacksonville Memorial 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.