CMS Price Transparency Data

CT scan, sinuses

Facility: Catawba Valley Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $229
Cash Discount Price: $1,462
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Catawba Valley Medical Center is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,462. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.14x the Medicare baseline. Located in 810 Fairgrove Church Rd, Hickory, NC.

Cash / Self-Pay

$1,462

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $1,462 (1369%)

Insurance Median: $229 (214%)

Cash: $1,462 (1369% of Medicare)

Ins. Median: $229 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Cigna	$102 - $1,340	95%
Humana	$104 - $1,949	97%
Wellcare	$105	98%
Blue Cross Blue Shield	$107 - $1,189	100%
Devoted Health	$107	100%
Gateway	$107	100%
Longevity Healthcare	$107	100%
Liberty Advantage	$108	101%
Troy	$108	101%
Mdsave	$111	104%
UnitedHealthcare	$149 - $2,331	140%
Caresource North Carolina	$229	214%
Directnet	$450	421%
Medcost	$1,218 - $2,314	1140%
Aetna	$1,484	1389%
Prime Health Service	$1,827	1711%
Multiplan	$2,071	1939%

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 $1,462.
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 Catawba Valley 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.