CMS Price Transparency Data

CT scan, sinuses

Facility: Shore Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $341
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Shore Medical Center is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.19x the Medicare baseline. Located in 100 Medical Center Way, Somers Point, NJ.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$341

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: $134 (125%)
Insurance Median: $341 (319%)
Cash: $134 (125% of Medicare)
Ins. Median: $341 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Aetna $56 - $569 52%
Amerihealth $116 - $825 109%
Clover $116 109%
Horizon $116 - $528 109%
UnitedHealthcare $116 - $446 109%
Wellpoint $117 - $603 110%
Oxford $168 157%
Fidelis Care $446 418%
Cigna $971 909%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Medical Center Way, Somers Point, NJ 08244
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals