CMS Price Transparency Data

CT scan, sinuses

Facility: Essentia Health Sandstone

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,290
  • Cash Discount Price: $1,392
  • vs. Medicare Baseline: 12.08x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Essentia Health Sandstone is $1,290. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,392. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.08x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$1,392

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,290

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: $1,392 (1303%)
Insurance Median: $1,290 (1208%)
Cash: $1,392 (1303% of Medicare)
Ins. Median: $1,290 (1208% 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 1208% of the Medicare baseline (a markup of 1108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Itasca Med Care $106 99%
Primewest $106 99%
Blue Cross Blue Shield $723 - $1,512 677%
Blue Plus Pmap Pcc Prime $723 - $1,036 677%
Medica Access $749 - $1,173 701%
Healthpartners Care Pmap $757 709%
Sanford Healthplan $808 - $850 756%
Advocare/Security Health $885 829%
Freedom Blue Ppo $885 829%
Healthpartners Care Msho / Mcr Adv $885 829%
Imcare Msho Pcc Prime $885 829%
Imcare Msho Ref Req $885 829%
Medica Advantage Solutions $885 829%
Medica Msho/Dual Solutions $885 829%
Medica Prime Solution Group $885 829%
Medicare (plans) $885 829%
Nd Va Administration $885 829%
Platinum Blue/Vantage Blue $885 829%
Primewest Msho $885 829%
Secure Blue Msho $885 829%
Ubh Cost Plan $885 829%
Ubh Msho $885 829%
Ucare Msho $885 829%
UnitedHealthcare $885 - $1,714 829%
Ucare $1,239 1160%
Healthpartners $1,273 - $1,501 1192%
Medica $1,346 - $1,497 1260%
Medica Uplan $1,346 1260%
Wea $1,356 - $1,450 1270%
America'S Ppo $1,459 1366%
Cigna $1,469 - $1,501 1375%
Healthpartners Pcc Prime $1,469 - $1,501 1375%
Medica Choice $1,542 1444%
Wps $1,563 - $1,582 1463%
Aetna $1,601 1499%
Security Health $1,883 1763%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals