CMS Price Transparency Data

CT scan, sinuses

Facility: University of Michigan Health - West

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $968
Cash Discount Price: $578
vs. Medicare Baseline: 9.06x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at University of Michigan Health - West is $968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $578. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.06x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$578

Average discount available for prompt cash payment at this facility.

Insurance Median

$968

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: $578 (541%)

Insurance Median: $968 (906%)

Cash: $578 (541% of Medicare)

Ins. Median: $968 (906% 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 906% of the Medicare baseline (a markup of 806%). 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
Medicaid / KanCare	$57 - $340	53%
Molina Healthcare Of Mi	$57	53%
Care Resources	$96	90%
Humana	$107 - $1,083	100%
Insight Metro Care	$107	100%
Medicare (plans)	$107	100%
Molina Marketplace Commercial	$107	100%
Priority Health	$266	249%
Aetna	$573 - $968	536%
Web Tpa	$635	595%
Alliance Health & Life Ppo	$968	906%
Asr Physicians	$968	906%
Hap	$968	906%
Golden Rule Ins	$1,041	975%
Medica	$1,041	975%
Student Ins/Mega Life	$1,041	975%
UnitedHealthcare	$1,041	975%
Asr Cofinity	$1,206	1129%
Cofinity Commercial	$1,206	1129%
Cofinity Weyco	$1,206	1129%
Core Source	$1,206	1129%
Epoch Group	$1,206	1129%
Health Partners	$1,206	1129%
Hlthcomp Admin	$1,206	1129%
Mid America	$1,206	1129%

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 $578.
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 University of Michigan Health - West 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.