CMS Price Transparency Data

CT scan, sinuses

Facility: Decatur County Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $515
Cash Discount Price: $820
vs. Medicare Baseline: 4.82x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Decatur County Memorial Hospital is $515. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $820. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.82x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$820

Average discount available for prompt cash payment at this facility.

Insurance Median

$515

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: $820 (768%)

Insurance Median: $515 (482%)

Cash: $820 (768% of Medicare)

Ins. Median: $515 (482% 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 482% of the Medicare baseline (a markup of 382%). 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	$30 - $1,397	28%
Aetna	$38 - $980	36%
Blue Cross Blue Shield	$38 - $1,592	36%
Caresource Mcr Adv	$38 - $541	36%
Choice Care Mcr Adv	$38 - $515	36%
Choicecare Commercial-All Other Plans	$38 - $1,653	36%
Encircle-All Plans	$38 - $1,397	36%
Siho Mcr Adv	$38 - $515	36%
Thcg/Encore-All Plans	$38 - $1,670	36%
Caresource Just4Me-All Other Plans	$44 - $876	41%
Cigna	$62 - $1,200	58%
Medicaid / KanCare	$104 - $118	97%
Siho-All Other Plans	$287 - $1,724	269%
Sagamore Health-All Plans	$328 - $1,422	307%
Healthsource Indiana-All Plans	$369 - $1,599	345%

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 $820.
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 Decatur County 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.