CMS Price Transparency Data

CT scan, sinuses

Facility: Henry County Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $280
Cash Discount Price: $1,432
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Henry County Memorial Hospital is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,432. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.62x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$1,432

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $1,432 (1341%)

Insurance Median: $280 (262%)

Cash: $1,432 (1341% of Medicare)

Ins. Median: $280 (262% 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 262% of the Medicare baseline (a markup of 162%). 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
UnitedHealthcare	$33 - $2,988	31%
Blue Cross Blue Shield	$38 - $2,809	36%
Caresource Hip	$38 - $112	36%
Humana	$38 - $3,230	36%
Caresource Mcr Adv	$39 - $114	37%
Aetna	$41 - $3,120	38%
Caresource Marketplace-All Other Plans	$51 - $213	48%
Caresource Just4Me	$57 - $280	53%
Encore Workers Comp-All Plans	$66 - $3,487	62%
Caresource Mcaid	$107 - $121	100%
Cigna	$207 - $2,496	194%
Health Alliance-All Plans	$351 - $3,120	329%
Workers Comp - All Plans	$372 - $3,304	348%

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 $1,432.
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 Henry County 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.