CMS Price Transparency Data

CT scan, sinuses

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 70486 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$296

about 2.8× the $107 Medicare rate · typically $137–$296

modeled estimate · not a bill or quote

What this hospital charges insurers

$238

Below the fair price — a good deal

about $58 under the fair price · 2.2× Medicare

Medicare pays $107 Fair price $296 This hospital $238 Cash price $1,773 Hospital's list price $2,728

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $41 Priciest $238

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, sinuses is about $296 (about 2.8× the $107 Medicare rate). Saint Joseph Regional Medical Center - Plymouth charges insurers about $238, or about $1,773 in cash — below the fair price — a good deal. Located in Plymouth, IN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$57 - $878	53%
Blue Cross Blue Shieldmajor	$57 - $406	53%
Aetnamajor	$57 - $1,773	53%
Cignamajor	$1,964	1839%
AvMed	$2,455	2298%
CareSource	$171	160%
Dean Health Plan	$2,455	2298%
GEHA	$878	822%
Health Net	$1,964 - $2,101	1839%
HealthPartners	$1,964	1839%
Medical Mutual	$1,773	1660%
Meridian	$111	104%
MVP Health Care	$1,964	1839%
Paramount	$2,455	2298%
Priority Health	$1,964	1839%
+ 53 smaller / regional plans	$111 - $2,728

Government programs also on file: Medicare, Medicaid.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,773), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70486.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph Regional Medical Center - Plymouth is in-network.
Ask your insurer whether prior approval is required for CPT code 70486.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph Regional Medical Center - Plymouth

Compare: CT scan, sinuses at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.