CMS Price Transparency Data

CT scan, sinuses

Facility: Portsmouth Regional Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $640
  • Cash Discount Price: $7,415
  • vs. Medicare Baseline: 5.99x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Portsmouth Regional Hospital is $640. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,415. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.99x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$7,415

Average discount available for prompt cash payment at this facility.

Insurance Median
$640

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: $7,415 (6942%)
Insurance Median: $640 (599%)
Cash: $7,415 (6942% of Medicare)
Ins. Median: $640 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Blue Cross Blue Shield $173 - $3,285 162%
Amerihealth Caritas $306 286%
Harvard Pilgrim $387 - $484 362%
Well Sense Health Plan $607 568%
United $1,906 - $4,894 1784%
Maine Community Health $2,319 - $3,929 2171%
Tufts Health Plan $2,788 - $4,241 2610%
Aetna $4,694 4395%
Corvel $5,339 4999%
Evernorth $5,932 5554%
Mutual Of Omaha $5,932 5554%
Multiplan $6,006 5623%
First Health $6,748 6318%
Healthcare Value Mgmt $6,748 6318%
Oxford Health Plans $7,044 6595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals