CMS Price Transparency Data

CT scan, sinuses

Facility: Rush Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $279
Cash Discount Price: $483
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Rush Memorial Hospital is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $483. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.61x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$483

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $483 (452%)

Insurance Median: $279 (261%)

Cash: $483 (452% of Medicare)

Ins. Median: $279 (261% 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 261% of the Medicare baseline (a markup of 161%). 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 - $739	31%
Caresource Mcr Adv	$38 - $287	36%
Humana	$38 - $850	36%
Aetna	$39 - $850	37%
Blue Cross Blue Shield	$39 - $677	37%
Today'S Option Mcr Adv-All Plans	$39 - $295	37%
Viant Beech St Mcr Adv	$39 - $295	37%
My True Advantage - All Plans	$40 - $287	37%
Consumers Life Ins-All Plans	$41 - $832	38%
Caresource Marketplace-All Other Plans	$51 - $458	48%
Multiplan-All Plans	$53 - $860	50%
Encore Health Services-All Plans	$66 - $906	62%
Siho-All Plans	$66 - $850	62%
Phcs-All Plans	$92 - $739	86%
Cigna	$182 - $739	170%
Health Net	$182 - $272	170%
Coventry/First Health-All Plans	$255 - $832	239%
Sagamore-All Plans	$850	796%
Community Health Alliance-All Plans	$869	814%

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 $483.
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 Rush 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.