CMS Price Transparency Data

CT scan, sinuses

Facility: Carolina East Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $977
Cash Discount Price: $1,031
vs. Medicare Baseline: 9.15x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Carolina East Medical Center is $977. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,031. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.15x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$1,031

Average discount available for prompt cash payment at this facility.

Insurance Median

$977

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: $1,031 (965%)

Insurance Median: $977 (915%)

Cash: $1,031 (965% of Medicare)

Ins. Median: $977 (915% 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 915% of the Medicare baseline (a markup of 815%). 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
Humana	$38 - $100	36%
Inclusive Health (Nchirp)-All Plans	$38 - $100	36%
Tricare	$38 - $2,331	36%
Pamlico Co Jail-All Plans	$294 - $620	275%
UnitedHealthcare	$386 - $1,657	361%
Craven Co. Jail Systems - All Plans	$435 - $786	407%
Medcost Ppo Employees And Retirees	$725 - $1,531	679%
Medcost Ppo Ultra (Employees)	$725 - $1,458	679%
Blue Cross Blue Shield	$771 - $1,599	722%
Medcost Ppo City Employees	$804 - $1,698	753%
Medcost Ppo County Employee	$836 - $1,766	783%
Benefit Mgmt, Svcs-All Plans	$938 - $1,981	878%
Medcost Benefit Svc-All Other Plans	$976 - $2,060	914%
Aetna	$978 - $2,065	916%
Acs Consult Svc Inc-All Plans	$997 - $2,105	933%
Medcost Ppo Standard	$997 - $2,105	933%
Cigna	$1,005 - $2,121	941%

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 $1,031.
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 Carolina East 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.