CMS Price Transparency Data

CT scan, sinuses

Facility: Pioneer Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,626
  • Cash Discount Price: $1,370
  • vs. Medicare Baseline: 15.22x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Pioneer Medical Center is $1,626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,370. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.22x the Medicare baseline. Located in 301 W 7Th Ave, Big Timber, MT.
Cash / Self-Pay
$1,370

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,626

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: $1,370 (1283%)
Insurance Median: $1,626 (1522%)
Cash: $1,370 (1283% of Medicare)
Ins. Median: $1,626 (1522% 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 1522% of the Medicare baseline (a markup of 1422%). 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
Blue Cross Blue Shield $770 - $1,421 721%
Health Info Net Mcr Adv $770 721%
Healtnet Federal-All Plans $770 721%
Humana $770 - $1,575 721%
Triwest Va Pccc-All Plans $770 721%
UnitedHealthcare $770 - $1,626 721%
Rocky Mountain Health Network-All Plans $1,198 1122%
Allegiance Provider-All Plans $1,455 1362%
Mountain Health Co-Op Hpn $1,507 1411%
6 Degrees Health-All Plans $1,626 1522%
Americas Choice-All Plans $1,626 1522%
City Of Billings-All Plans $1,626 1522%
Community Health Ntwk-All Plans $1,626 1522%
Ebms Select Care Network-All Plans $1,626 1522%
Fedmed Network-All Plans $1,626 1522%
First Choice Big Sky-All Plans $1,626 1522%
First Health-All Plans $1,626 1522%
Interwest Ppo $1,626 1522%
Mountain Health Co-Op-All Other Plans $1,626 1522%
Pacific Source-All Plans $1,626 1522%
Pacific Steel & Recycling-All Plans $1,626 1522%
Three Rivers-All Plans $1,626 1522%
Health Info Net Peak/Equity $1,661 1555%
Health Info Net Standard-All Other Plans $1,661 1555%
Mountain Health Co-Op Ppo/Pos $1,678 1571%
Interwest Health Traditional-All Other Plans $1,712 1603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 W 7Th Ave, Big Timber, MT 59011
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals