CMS Price Transparency Data

CT scan, sinuses

Facility: North Carolina Baptist Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $729
Cash Discount Price: $1,088
vs. Medicare Baseline: 6.83x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at North Carolina Baptist Hospital is $729. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,088. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.83x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$1,088

Average discount available for prompt cash payment at this facility.

Insurance Median

$729

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: $1,088 (1019%)

Insurance Median: $729 (683%)

Cash: $1,088 (1019% of Medicare)

Ins. Median: $729 (683% 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 683% of the Medicare baseline (a markup of 583%). 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 - $1,900	96%
Apex	$103	96%
Blue Cross Blue Shield	$103 - $821	96%
Cigna	$103 - $1,341	96%
Devoted	$103	96%
Healthteam	$103	96%
UnitedHealthcare	$103 - $1,178	96%
Wellcare	$103 - $512	96%
Humana	$104 - $1,223	97%
Medicare (plans)	$104	97%
Liberty	$118	110%
Medcost	$419 - $1,486	392%
Amerihealth	$479 - $602	448%
Carolina Complete	$479 - $505	448%
Health Blue	$479 - $505	448%
Partners	$479 - $505	448%
Vaya	$484 - $510	453%
Alliance	$488 - $515	457%
Trillium	$493 - $520	462%
Ambetter / Centene	$572 - $603	536%
Oscar	$635 - $805	595%
Directnet	$1,252 - $1,321	1172%
Cone Health	$1,483 - $1,564	1388%
Healthgram	$1,483 - $1,564	1388%
First Carolina Care	$1,694 - $1,788	1586%
Private Healthcare Systems	$1,737 - $1,833	1626%
Multiplan	$1,906 - $2,012	1784%

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 $1,088.
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 North Carolina Baptist 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.