CMS Price Transparency Data

CT scan, sinuses

Facility: PAM Rehabilitation Hospital of Fargo

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,070
Cash Discount Price: $2,855
vs. Medicare Baseline: 19.38x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at PAM Rehabilitation Hospital of Fargo is $2,070. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,855. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.38x the Medicare baseline. Located in 4671 38Th St S, Fargo, ND.

Cash / Self-Pay

$2,855

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,070

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: $2,855 (2673%)

Insurance Median: $2,070 (1938%)

Cash: $2,855 (2673% of Medicare)

Ins. Median: $2,070 (1938% 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 1938% of the Medicare baseline (a markup of 1838%). 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	$99	93%
Primewest Minnesota	$99	93%
Ucare Of Minnesota	$99	93%
Medica	$605 - $1,211	566%
Sanford Health Plan	$1,328	1243%
Cigna	$1,713 - $1,998	1604%
Ilumed Aco Reach	$1,856	1738%
Americas Choice Provider Network	$1,998	1871%
Provider Network Of America	$2,141	2004%
Quik Trip	$2,141	2004%
Usa Managed Care Organization	$2,141	2004%
Velocity Provider Ppo Network	$2,141	2004%
Multiplan/Phcs	$2,284	2138%
Prime Health Services	$2,427	2272%

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 $2,855.
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 PAM Rehabilitation Hospital of Fargo 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.