CMS Price Transparency Data

CT scan, sinuses

Facility: Boston Children's Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,501
Cash Discount Price: $2,114
vs. Medicare Baseline: 14.05x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Boston Children's Hospital is $1,501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,114. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.05x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$2,114

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,501

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: $2,114 (1979%)

Insurance Median: $1,501 (1405%)

Cash: $2,114 (1979% of Medicare)

Ins. Median: $1,501 (1405% 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 1405% of the Medicare baseline (a markup of 1305%). 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
Unicare	$623	583%
Blue Cross Blue Shield	$672 - $1,396	629%
Cdphp	$1,036 - $1,797	970%
Harvard Pilgrim	$1,074 - $1,428	1006%
United	$1,264 - $1,766	1183%
Aetna	$1,268 - $1,772	1187%
Mgb/Allways	$1,286 - $1,563	1204%
Tufts Public Plan	$1,299 - $1,302	1216%
United Ri Nj Ny	$1,332	1247%
Ambetter / Centene	$1,336	1251%
Carelon Strategies/Bhs	$1,374	1286%
UnitedHealthcare	$1,374 - $1,797	1286%
Carelon/Beacon	$1,586	1485%
Fallon	$1,613 - $1,630	1510%
Health New England	$1,708	1599%
Cigna	$1,797 - $1,908	1682%
Ets/Lifetrac	$1,797	1682%
Interlink Transplant	$1,797	1682%
Community Health Options	$1,903	1782%
Humana	$1,903	1782%
Coventry/Hcvm/First Health	$1,945	1821%
Multiplan/Phcs	$1,945 - $2,008	1821%

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 $2,114.
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 Boston Children's 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.