CMS Price Transparency Data

CT scan, sinuses

Facility: Franciscan Health Rensselaer, Inc

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $481
  • Cash Discount Price: $552
  • vs. Medicare Baseline: 4.50x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Franciscan Health Rensselaer, Inc is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.50x the Medicare baseline. Located in 1104 E Grace St, Rensselaer, IN.
Cash / Self-Pay
$552

Average discount available for prompt cash payment at this facility.

Insurance Median
$481

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: $552 (517%)
Insurance Median: $481 (450%)
Cash: $552 (517% of Medicare)
Ins. Median: $481 (450% 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 450% of the Medicare baseline (a markup of 350%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $227 - $267 213%
Unicare [1150] $254 238%
Medicare (plans) $386 361%
Mdwise [1175] $406 380%
Medicaid / KanCare $406 - $488 380%
Managed Health Services [1302] $419 392%
Commercial [2001] $481 - $1,234 450%
Managed Care [2000] $481 - $1,234 450%
Workers Comp [1172] $772 723%
United Medical Resources [1158] $946 886%
United Medical Resources [1301] $946 886%
UnitedHealthcare $946 886%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1104 E Grace St, Rensselaer, IN 47978
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals