CMS Price Transparency Data

CT scan, sinuses

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $453
Cash Discount Price: $1,534
vs. Medicare Baseline: 4.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Memorial Hospital for Cancer and Allied Diseases is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,534. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.24x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$1,534

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

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: $1,534 (1436%)

Insurance Median: $453 (424%)

Cash: $1,534 (1436% of Medicare)

Ins. Median: $453 (424% 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 424% of the Medicare baseline (a markup of 324%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$43 - $1,685	40%
Fidelis	$43 - $954	40%
Healthfirst	$43 - $1,666	40%
Metroplus	$43 - $1,805	40%
Emblem	$136 - $1,924	127%
Oxford	$156 - $1,863	146%
Empire	$164 - $687	154%
Cigna	$192 - $654	180%
UnitedHealthcare	$194 - $1,985	182%
Magnacare	$209 - $2,222	196%
Urn	$226 - $1,972	212%
6 Degrees Health	$232 - $2,166	217%
Multiplan	$261 - $2,499	244%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,534.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Hospital for Cancer and Allied Diseases is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.