CMS Price Transparency Data

CT scan, sinuses

Facility: Carlsbad Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,342
  • Cash Discount Price: $871
  • vs. Medicare Baseline: 21.93x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Carlsbad Medical Center is $2,342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $871. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.93x the Medicare baseline. Located in 2430 West Pierce Street, Carlsbad, NM.
Cash / Self-Pay
$871

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,342

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: $871 (815%)
Insurance Median: $2,342 (2193%)
Cash: $871 (815% of Medicare)
Ins. Median: $2,342 (2193% 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 2193% of the Medicare baseline (a markup of 2093%). 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
Veterans Eval Services $97 91%
Department Of Veterans Affairs $104 97%
Tricare $104 97%
Medicaid / KanCare $108 - $248 101%
Blue Cross Blue Shield $109 - $5,244 102%
Medicare (plans) $109 102%
Node Molina Mcr Adv $109 102%
Presbyterian $109 - $4,198 102%
Node Va $111 104%
Triwest $111 104%
UnitedHealthcare $113 - $2,992 106%
Node Choice Care Mcr Adv $115 108%
Node Devoted Health Mcr Adv $115 108%
Us Department Of Labor $139 130%
Wexford Health $139 130%
Work Comp Nm $273 - $2,091 256%
Node Molina Health Exchange $303 284%
Nm Health Connection $443 415%
Self Pay $581 - $1,162 544%
Capstar $1,384 1296%
Cigna $2,655 - $4,868 2486%
Eddy County Detention $2,904 2719%
Zelis $3,660 - $4,880 3427%
Omni Network $3,776 3535%
Choice Care $4,066 3807%
Ccn First Health $4,647 4351%
Healthsmart $4,705 - $4,996 4405%
Aetna $4,880 4569%
Multiplan $4,880 4569%
Medical Control Inc $5,402 5058%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2430 West Pierce Street, Carlsbad, NM 88220
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals