CMS Price Transparency Data

CT scan, sinuses

Facility: Novant Health Presbyterian Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $967
Cash Discount Price: $909
vs. Medicare Baseline: 9.05x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Novant Health Presbyterian Medical Center is $967. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $909. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.05x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$909

Average discount available for prompt cash payment at this facility.

Insurance Median

$967

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: $909 (851%)

Insurance Median: $967 (905%)

Cash: $909 (851% of Medicare)

Ins. Median: $967 (905% 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 905% of the Medicare baseline (a markup of 805%). 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	$102 - $1,307	95%
Humana	$102 - $1,595	95%
Pace Of The Southern Piedmont	$102	95%
UnitedHealthcare	$102 - $1,294	95%
Aetna	$104 - $1,772	97%
Cigna	$105 - $1,141	98%
Liberty Health	$107	100%
Nc Department Of Public Safety	$203 - $386	190%
Carolina Complete	$272 - $386	255%
Amerihealth	$277 - $394	259%
Wellcare	$277 - $394	259%
Caresource North Carolina	$514 - $731	481%
Atlantic Corporation Dba Atlantic Packaging	$717 - $1,019	671%
Amps	$857 - $1,218	802%
Plotkin Health	$935 - $1,329	875%
Medcost	$1,107 - $1,661	1036%
Primary Physician Care	$1,154 - $1,639	1080%
Multiplan	$1,169 - $1,661	1094%
Phcs	$1,169 - $1,661	1094%
Employers Choice Network	$1,512 - $2,149	1416%
Three Rivers Provider Network	$1,512 - $2,149	1416%

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 $909.
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 Novant Health Presbyterian Medical Center 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.