CMS Price Transparency Data

CT scan, sinuses

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $3,650
  • Cash Discount Price: $6,167
  • vs. Medicare Baseline: 34.17x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at University Medical Center of Princeton at Plainsboro is $3,650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,167. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 34.17x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$6,167

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,650

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: $6,167 (5774%)
Insurance Median: $3,650 (3417%)
Cash: $6,167 (5774% of Medicare)
Ins. Median: $3,650 (3417% 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 3417% of the Medicare baseline (a markup of 3317%). 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
Tricare $118 110%
Aetna $119 - $5,137 111%
Blue Cross Blue Shield $119 - $4,639 111%
Medicare (plans) $119 - $131 111%
UnitedHealthcare $119 - $2,399 111%
Va Medical Center $119 111%
Cigna $123 - $6,167 115%
Clover Health Plan $126 118%
Humana $129 121%
Us Family Health Plan $135 126%
Elap $169 - $215 158%
Centivo $215 201%
Claim Watcher $215 201%
Horizon Nj Health $220 206%
Medicaid / KanCare $569 - $6,167 533%
Charity Care $577 540%
Wellcare $625 585%
Preferred Health Care Eliance $1,603 1501%
Horizon Behavioral Health $2,312 2165%
Beacon Health Options $3,084 2887%
Amerihealth $3,650 3417%
Magnacare $3,700 - $4,317 3464%
Princeton Theological Seminary $4,009 3753%
Coventry $4,317 4042%
Health Net $4,317 4042%
Beech Street $4,934 - $5,242 4619%
Intergrated Health Plan $4,934 4619%
Intergroup $4,934 4619%
Penn Global Medicine Embassy Only $4,934 4619%
Allied Trades $5,242 4908%
Consumer Health Network $5,242 4908%
Devon Health Services $5,242 4908%
First Managed Care Option $5,242 4908%
Ie Shaffer $5,242 4908%
Private Healthcare Systems $5,242 4908%
Qualcare $5,242 4908%
Total Care Network $5,242 4908%
Tri-State $5,242 4908%
Commercial Other $6,167 5774%
Compsych $6,167 5774%
Concern Plus $6,167 5774%
International Pfs $6,167 5774%
Life St. Francis $6,167 5774%
Magellan $6,167 5774%
Managed Health Network $6,167 5774%
Nj Carpenters $6,167 5774%
Penn Behavioral Health Corporate Services $6,167 5774%
Personnel Health Program $6,167 5774%
United Behavioral Health $6,167 5774%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals