CMS Price Transparency Data

CT scan, sinuses

Facility: St Louis Childrens Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $836
Cash Discount Price: $675
vs. Medicare Baseline: 7.83x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at St Louis Childrens Hospital is $836. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $675. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.83x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$675

Average discount available for prompt cash payment at this facility.

Insurance Median

$836

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: $675 (632%)

Insurance Median: $836 (783%)

Cash: $675 (632% of Medicare)

Ins. Median: $836 (783% 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 783% of the Medicare baseline (a markup of 683%). 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	$103 - $889	96%
Blue Cross Blue Shield	$103 - $956	96%
Essence Healthcare [221]	$103	96%
Humana	$103 - $838	96%
UnitedHealthcare	$103 - $836	96%
Cox Health [757]	$108	101%
Medica [662]	$108	101%
Healthlink [225]	$546 - $849	511%
Cigna	$556 - $611	521%
Consociate [478]	$610	571%
Sarah Bush Lincoln [636]	$610	571%
Apwu Health Plan [216]	$611	572%
Nalc Health Benefit Plan [242]	$611	572%
Priority Health [648]	$611	572%
Allied Benefits [498]	$652 - $889	610%
Hope Trust [806]	$652	610%
Cox Health Systems Insurance Company [220]	$731 - $832	684%
Med-Pay [480]	$731 - $844	684%
Unicare [568]	$731 - $849	684%
Healthscope Benefits [258]	$802 - $900	751%
First Health Commercial [734]	$836	783%
Beechstreet [551]	$844	790%
Detego Health [868]	$844	790%
Health Systems Inc [620]	$844	790%
Healthcare Sol Mercy [609]	$844	790%
Multiplan Commercial [737]	$844	790%
Multiplan [240]	$844	790%
Phcs [244]	$844 - $900	790%
Preferred Health Professionals [561]	$849	795%
Coresource [497]	$889	832%
Fmh Benefit Service Inc [222]	$889	832%
Mail Handlers [495]	$889	832%
Medica [661]	$900	843%
Hfn [563]	$956	895%
Health Alliance [224]	$1,700	1592%

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 $675.
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 St Louis Childrens 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.