CMS Price Transparency Data

CT scan, sinuses

Facility: Pulaski Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $118
Cash Discount Price: $166
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Pulaski Memorial Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.10x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $166 (155%)

Insurance Median: $118 (110%)

Cash: $166 (155% of Medicare)

Ins. Median: $118 (110% 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
Ambetter / Centene	$38 - $834	36%
Blue Cross Blue Shield	$38 - $1,730	36%
Caresource Mcaid Hip	$38 - $834	36%
Caresource Mcare Hmo	$38 - $834	36%
Cenpatico Mcaid Hip	$38 - $834	36%
Humana	$38 - $2,162	36%
Mdwise Mcaid Hcc	$38 - $104	36%
Mdwise Mcaid Hhw	$38 - $104	36%
Mdwise Mcaid Hip - All Other Plans	$38 - $834	36%
Mhs Mcaid Hip	$38 - $834	36%
Mhs Mcare Allwell	$38 - $842	36%
Multiplan - All Plans	$38 - $2,420	36%
UnitedHealthcare	$38 - $2,125	36%
Caresource Exch Hmo Hix - All Other Plans	$48 - $1,042	45%
Encore Ppo - All Other Plans	$58 - $2,286	54%
Community Health Alliance - All Plans	$74 - $2,393	69%
Cigna	$87 - $2,555	81%
Sagamore - All Other Plans	$87 - $2,033	81%
Sagamore Rose Acre	$87 - $2,004	81%
Caresource Mcaid Hhw	$104 - $118	97%
Cenpatico Mcaid Hhw - All Other Plans	$104 - $118	97%
Mhs Mcaid Hhw/Hcc	$104 - $118	97%
Encore Workers Comp	$107 - $2,420	100%
Aetna	$968	906%

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 $166.
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 Pulaski 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.