CMS Price Transparency Data

CT scan, sinuses

Facility: Elmhurst Hospital Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $346
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 3.24x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Elmhurst Hospital Center is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.24x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$346

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%)
Insurance Median: $346 (324%)
Ins. Median: $346 (324% 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 324% of the Medicare baseline (a markup of 224%). 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
Healthfirst $35 - $830 33%
Aetna $43 - $1,131 40%
Amidacare $44 - $369 41%
Emblem $44 - $498 41%
Wellcare $47 - $159 44%
Metroplus $56 - $830 52%
Fidelis $63 - $830 59%
Oscar $65 - $1,228 61%
United $120 - $468 112%
Blue Cross Blue Shield $126 - $830 118%
Vaccn $126 118%
Vnsny $126 - $497 118%
Senior Whole Health $127 - $369 119%
Centers Plan For Healthy Living $131 123%
Elderplan $252 - $380 236%
Oxford $292 - $351 273%
Centerlight $293 274%
Carelon $369 - $380 345%
United Behavioral Health $369 - $406 345%
Affinity $376 - $830 352%
Carelon (Amida Care) $376 352%
Magnacare $439 411%
Multiplan $468 438%
Local 1199 $497 465%
Villagecare Max $497 465%
Cigna $1,056 989%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals