CMS Price Transparency Data

CT scan, sinuses

Facility: Cox Medical Centers

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $686
Cash Discount Price: $600
vs. Medicare Baseline: 6.42x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Cox Medical Centers is $686. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $600. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.42x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$600

Average discount available for prompt cash payment at this facility.

Insurance Median

$686

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: $600 (562%)

Insurance Median: $686 (642%)

Cash: $600 (562% of Medicare)

Ins. Median: $686 (642% 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 642% of the Medicare baseline (a markup of 542%). 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
Cox Healthplans	$52 - $104	49%
Health Net Federal Services	$52 - $104	49%
Humana	$52 - $104	49%
Medrisk Llc	$52 - $104	49%
UnitedHealthcare	$52 - $1,715	49%
Blue Cross Blue Shield	$53 - $1,006	50%
Allwell	$54 - $107	51%
Devoted	$56 - $111	52%
Provider Partners Health Plan	$56 - $111	52%
Parkcrest Dental Group	$760	712%
Coastal Energy Corporation	$768	719%
Heart Of America Beverage Company	$783	733%
Loren Cook	$799	748%
Springfieldgreene Co Library	$814	762%
Src Holdings Corporation	$821	769%
Ozark Anesthesia Assoc. Inc	$831	778%
Missouri Affiliated School Consortium (Masc)	$853	799%
Justice Furniture And Bedding Co	$857	802%
The Durham Company	$857	802%
Ozark County	$863	808%
Ozarks Cocacola	$871	815%
Flora Farms	$887	830%
Advanced Concrete Technology	$897	840%
Bjc Health Solutions	$2,381	2229%

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 $600.
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 Cox Medical Centers 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.