CMS Price Transparency Data

CT scan, sinuses

Facility: M Health Fairview Southdale Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $195
Cash Discount Price: $552
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at M Health Fairview Southdale Hospital is $195. 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 1.83x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$552

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $195 (183%)

Cash: $552 (517% of Medicare)

Ins. Median: $195 (183% 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
Health Partners	$28 - $319	26%
Itasca Medical Care	$28 - $125	26%
Primewest	$28 - $125	26%
South Country Health Alliance	$28 - $125	26%
Ucare	$28 - $349	26%
Medica	$30 - $841	28%
Hennepin Health	$31 - $108	29%
Blue Cross Blue Shield	$32 - $488	30%
Sanford Health Plan	$38 - $825	36%
Security Health Plan	$38 - $1,050	36%
UnitedHealthcare	$38 - $500	36%
Wellcare	$38 - $125	36%
America'S Ppo	$705 - $1,008	660%
First Health	$1,110 - $1,148	1039%
Multiplan	$1,151 - $1,190	1078%
Private Healthcare Systems	$1,151 - $1,190	1078%
Wisconsin Physician Services	$1,219 - $1,260	1141%

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 $552.
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 M Health Fairview Southdale 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.