CMS Price Transparency Data

CT scan, sinuses

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,901
  • Cash Discount Price: $2,538
  • vs. Medicare Baseline: 27.16x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Ann & Robert H Lurie Childrens Hospital of Chicago is $2,901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,538. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 27.16x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$2,538

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,901

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: $2,538 (2376%)
Insurance Median: $2,901 (2716%)
Cash: $2,538 (2376% of Medicare)
Ins. Median: $2,901 (2716% 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 2716% of the Medicare baseline (a markup of 2616%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicare (plans) $616 - $2,656 577%
Magellan $900 - $2,901 843%
UnitedHealthcare $1,126 - $1,210 1054%
Mercycare Health $1,342 1256%
Blue Cross Blue Shield $1,512 - $2,901 1416%
Cigna $1,523 - $2,574 1426%
Aetna $1,813 - $2,614 1697%
Beacon Health Options $1,813 1697%
La Rabida Childrens Hospital $1,813 1697%
Centegra $2,176 2037%
Independent Physicians At Mercy $2,176 2037%
Advanced Physicians Association Ipa $2,538 2376%
Health Plus $2,538 2376%
Imagine Health $2,538 2376%
Methodist First Choice $2,538 2376%
Northwest Community Healthcare $2,538 2376%
Presence Health Partners $2,538 2376%
St. Francis $2,538 2376%
Ui Health $2,538 2376%
West Suburban Health Providers $2,538 2376%
Shriners Hospital $2,720 2547%
Swedish Covenant Physician Partners $2,720 2547%
American Psych Systems $2,901 2716%
Health Alliance $2,901 2716%
Macneal Health $2,901 2716%
Healthlink Inc. $2,991 2800%
Cofinity $3,082 2885%
Hfn Inc $3,082 - $3,263 2885%
Humana $3,082 2885%
Principal Healthcare $3,082 2885%
St. Elizabeth $3,082 2885%
First Health $3,191 2988%
Healthstar $3,191 2988%
Preferred Health Network $3,191 2988%
Sagamore Health Network $3,191 2988%
Beech Street $3,263 3055%
Benchmark Health $3,263 3055%
Employer'S Coalition On Health $3,263 3055%
Private Health Care System $3,263 3055%
Security Health Plan $3,263 3055%
Swedish American $3,263 3055%
Wellmark/Healthnetwork $3,336 3123%
Health Smart $3,445 3225%
Integrated Health Plan $3,445 3225%
Multiplan $3,445 3225%
National Provider Network $3,445 3225%
Wea Insurance Group $3,445 3225%
Unicare $3,678 - $8,500 3443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens