CMS Price Transparency Data

CT scan, sinuses

Facility: Wheatland Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $301
Cash Discount Price: $993
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Wheatland Memorial Hospital is $301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $993. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.82x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$993

Average discount available for prompt cash payment at this facility.

Insurance Median

$301

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: $993 (930%)

Insurance Median: $301 (282%)

Cash: $993 (930% of Medicare)

Ins. Median: $301 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Blue Cross Blue Shield	$40 - $64	37%
Healthnet Federal-All Plans	$40 - $1,007	37%
Humana	$40 - $1,007	37%
Pacific Source Mcr Adv	$40 - $1,007	37%
Triwest-All Plans	$40 - $1,007	37%
UnitedHealthcare	$40 - $1,618	37%
Medica Prime Solutions-All Plans	$41 - $1,007	38%
Naphcare-All Plans	$64	60%
Allegiance Provider-All Plans	$65 - $1,404	61%
First Choice Big Sky-All Plans	$66 - $1,569	62%
6 Degrees Health-All Plans	$72 - $1,569	67%
Ccn-All Plans	$72 - $1,602	67%
Community Health Ntwk-All Plans	$72 - $1,569	67%
First Health-All Plans	$72 - $1,585	67%
Interwest Ppo-All Plans	$72 - $1,569	67%
Mountain Health Co-Op-All Plans	$72 - $1,569	67%
Rocky Mountain Health Network-All Plans	$72 - $1,569	67%
Pacific Steel & Recycling-All Plans	$79 - $1,569	74%
City Of Billings-All Plans	$85 - $2,477	80%
Pacific Source-All Other Plans	$89 - $1,569	83%
Amish Old Orders-All Plans	$250 - $1,239	234%
Fedmed Network-All Plans	$284 - $1,569	266%
Americas Choice-All Plans	$317 - $1,569	297%
Three Rivers-All Plans	$317 - $1,569	297%

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 $993.
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 Wheatland Memorial 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.