CMS Price Transparency Data

CT scan, sinuses

Facility: Northwest Health-La Porte

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $367
  • Cash Discount Price: $619
  • vs. Medicare Baseline: 3.44x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Northwest Health-La Porte is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $619. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.44x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
$619

Average discount available for prompt cash payment at this facility.

Insurance Median
$367

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: $619 (580%)
Insurance Median: $367 (344%)
Cash: $619 (580% of Medicare)
Ins. Median: $367 (344% 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 344% of the Medicare baseline (a markup of 244%). 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
UnitedHealthcare $98 - $1,661 92%
Tricare $105 98%
Aetna $109 - $2,551 102%
Blue Cross Blue Shield $109 - $451 102%
Humana $109 - $406 102%
Medicare (plans) $109 102%
Lutheran $110 - $833 103%
Node Champva $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
Va Choice Program $111 104%
Indiana Dept Of Correction $115 108%
Managed Health Services $115 - $406 108%
Node Pphp Mcr Adv $116 109%
Self Pay $135 - $1,666 126%
Us Department Of Labor $139 130%
Php $169 - $1,274 158%
Lutheran Preferred Medpartners $171 - $1,290 160%
Alpha Baking $184 - $1,388 172%
Encore $200 - $2,777 187%
Prime Health In Work Comp $200 187%
In Wc $222 208%
Lutheran Network $222 - $2,715 208%
Php Freedom Network $246 - $1,857 230%
Encore Kba Epo $266 249%
Magnacare Ma $271 254%
One Call $275 257%
County Of Laporte $286 - $2,160 268%
Cigna $303 - $2,292 284%
Prime Health Services $306 - $2,314 286%
Prime Health Services Auto $306 - $2,314 286%
Caresource $313 - $406 293%
Ihn $327 - $2,468 306%
Encore Kba Ppo $333 312%
Community Health Alliance $355 - $2,684 332%
Sagamore Health Network $359 - $2,715 336%
Chandler Group $367 - $2,777 344%
Hfn Workers Compensation $367 - $2,777 344%
Multiplan $367 - $2,777 344%
Phcs $367 - $2,777 344%
Medicaid / KanCare $406 380%
Mhs $406 380%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals