CMS Price Transparency Data

CT scan, sinuses

Facility: Daviess Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $122
Cash Discount Price: $623
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Daviess Community Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 1314 E Walnut St, Washington, IN.

Cash / Self-Pay

$623

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $623 (583%)

Insurance Median: $122 (114%)

Cash: $623 (583% of Medicare)

Ins. Median: $122 (114% 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.

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	$38 - $1,682	36%
Blue Cross Blue Shield	$38 - $1,303	36%
Encore Ppo-All Plans	$38 - $850	36%
Humana	$38 - $146	36%
UnitedHealthcare	$40 - $1,413	37%
St. Vincent Health - All Plans	$42 - $1,093	39%
Patoka Valley-All Plans	$50 - $841	47%
Mdwise Marketplace-All Plans	$73 - $208	68%
Siho-All Plans	$89 - $1,514	83%
Sagamore Valley-All Plans	$96 - $1,632	90%
Caresource Mcaid-All Plans	$99 - $104	93%
Hoosier Healthwise Mcaid-All Plans	$99 - $104	93%

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 $623.
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 Daviess Community 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.