CMS Price Transparency Data

CT scan, sinuses

Facility: McLaren Central Michigan

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $66
Cash Discount Price: $522
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at McLaren Central Michigan is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $522. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.62x the Medicare baseline. Located in 1221 South Drive, Mount Pleasant, MI.

Cash / Self-Pay

$522

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $522 (489%)

Insurance Median: $66 (62%)

Cash: $522 (489% of Medicare)

Ins. Median: $66 (62% 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
Medicaid / KanCare	$26 - $60	24%
Humana	$39 - $104	37%
Medicare (plans)	$39 - $166	37%
U Of M Health Plan	$45 - $1,263	42%
Aetna	$52 - $1,457	49%
Priority Health	$59 - $983	55%
Blue Cross Blue Shield	$64 - $224	60%
Mclaren Commercial Ins	$66 - $677	62%
UnitedHealthcare	$66 - $1,457	62%
Tricare	$94	88%
Mi Amish Medical Board	$104	97%
Cofinity Auto	$197	184%
Workers Compensation	$884	828%

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 $522.
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 McLaren Central Michigan 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.