CMS Price Transparency Data

CT scan, sinuses

Facility: Memorial Community Hospital & Health System

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $929
  • Cash Discount Price: $1,486
  • vs. Medicare Baseline: 8.70x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Memorial Community Hospital & Health System is $929. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,486. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.70x the Medicare baseline. Located in 810 North 22Nd St, Blair, NE.
Cash / Self-Pay
$1,486

Average discount available for prompt cash payment at this facility.

Insurance Median
$929

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: $1,486 (1391%)
Insurance Median: $929 (870%)
Cash: $1,486 (1391% of Medicare)
Ins. Median: $929 (870% 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 870% of the Medicare baseline (a markup of 770%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $873 - $926 817%
Ne Total Care Mcaid-All Other Plans $873 817%
UnitedHealthcare $873 - $1,765 817%
Blue Cross Blue Shield $929 - $1,784 870%
Tricare $929 870%
Humana $938 - $1,672 878%
Medica Mcr Adv $985 922%
Medica Comm-All Other Plans $1,691 1583%
Multiplan (Phcs)-All Plans $1,821 1705%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 810 North 22Nd St, Blair, NE 68008
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals