CMS Price Transparency Data

CT scan, sinuses

Facility: Barnes Jewish Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,042
Cash Discount Price: $842
vs. Medicare Baseline: 9.76x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Barnes Jewish Hospital is $1,042. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $842. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.76x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$842

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,042

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: $842 (788%)

Insurance Median: $1,042 (976%)

Cash: $842 (788% of Medicare)

Ins. Median: $1,042 (976% 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 976% of the Medicare baseline (a markup of 876%). 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
Aetna	$105 - $1,052	98%
Blue Cross Blue Shield	$105 - $1,221	98%
Essence Healthcare [221]	$105	98%
Humana	$105 - $1,817	98%
UnitedHealthcare	$105 - $1,210	98%
Cox Health [757]	$110	103%
Devoted Health Plan [847]	$110	103%
Medica [662]	$110	103%
Healthlink [225]	$680 - $1,059	637%
Allied Benefits [498]	$757 - $1,042	709%
Coresource [497]	$757	709%
Fmh Benefit Service Inc [222]	$757	709%
Mail Handlers [495]	$757	709%
Cox Health Systems Insurance Company [220]	$772 - $912	723%
Hope Trust [806]	$814	762%
Healthscope Benefits [258]	$856 - $1,210	801%
Cigna	$872 - $1,405	816%
Med-Pay [480]	$912 - $1,052	854%
Unicare [568]	$912 - $1,059	854%
Consociate [478]	$970	908%
Sarah Bush Lincoln [636]	$970	908%
First Health Commercial [734]	$1,042	976%
Beechstreet [551]	$1,052	985%
Detego Health [868]	$1,052	985%
Health Systems Inc [620]	$1,052	985%
Healthcare Sol Mercy [609]	$1,052	985%
Multiplan Commercial [737]	$1,052	985%
Multiplan [240]	$1,052	985%
Phcs [244]	$1,052 - $1,122	985%
Preferred Health Professionals [561]	$1,059	991%
Medica [661]	$1,122	1050%
Hfn [563]	$1,193	1117%
Apwu Health Plan [216]	$1,378	1290%
Nalc Health Benefit Plan [242]	$1,378	1290%
Priority Health [648]	$1,378	1290%
Health Alliance [224]	$1,500	1404%

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 $842.
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 Barnes Jewish 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.