CMS Price Transparency Data

CT scan, sinuses

Facility: Albany Medical Center Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $104
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Albany Medical Center Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $124 (116%)
Insurance Median: $104 (97%)
Cash: $124 (116% of Medicare)
Ins. Median: $104 (97% 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.

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
Cdphp $26 - $819 24%
Blue Cross Blue Shield $29 - $819 27%
Medicare (plans) $29 - $138 27%
Fidelis $30 - $819 28%
Tricare $33 - $121 31%
Medicaid / KanCare $35 - $198 33%
Hamaspik $36 - $855 34%
Blue Shield Highmark $37 - $509 35%
UnitedHealthcare $38 - $1,676 36%
Mvp $39 - $364 37%
Aetna $40 - $388 37%
Emblem Health Ghi $42 - $266 39%
Nascentia $42 - $133 39%
Cigna $60 - $230 56%
Blue Shield $93 - $386 87%
Empire Plan Nyship $95 - $1,676 89%
Nys Department Of Corrections $95 - $300 89%
Multiplan $101 - $1,781 95%
Nascentia Health Options $184 172%
Emblem $189 - $312 177%
Mvp Commercial $301 282%
Emblem_Ghi $312 292%
Mvp Essential Plan $783 733%
Magnacare $4,998 4679%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals