CMS Price Transparency Data

CT scan, sinuses

Facility: Cheshire Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $365
Cash Discount Price: $502
vs. Medicare Baseline: 3.42x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Cheshire Medical Center is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.42x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$502

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

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: $502 (470%)

Insurance Median: $365 (342%)

Cash: $502 (470% of Medicare)

Ins. Median: $365 (342% 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 342% of the Medicare baseline (a markup of 242%). 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
Aetna	$41 - $1,832	38%
Ambetter / Centene	$42 - $102	39%
Blue Cross Blue Shield	$42 - $2,127	39%
Cigna	$42 - $1,326	39%
Martin'S Point Generations Advantage	$42 - $111	39%
Martin'S Point Health Care	$42 - $111	39%
Mvp	$42 - $1,326	39%
UnitedHealthcare	$42 - $2,033	39%
Wellcare Health Plans	$42 - $111	39%
Wellsense Health Plan	$42 - $369	39%
Mass General Brigham Health Plan	$106 - $2,678	99%
Amerihealth Caritas Nh	$118 - $328	110%
Tufts Health Plan	$119 - $1,709	111%
Harvard Pilgrim Health Care Of Ne	$139 - $1,218	130%
Granite State Health Plan	$149 - $447	140%
Maine Community Health Options	$433 - $1,205	405%
First Health/Hcvm	$819 - $2,276	767%
Phcs	$867 - $2,410	812%

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 $502.
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 Cheshire 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.