CMS Price Transparency Data

CT scan, sinuses

Facility: NYU Langone Hospitals

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $509
Cash Discount Price: $796
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at NYU Langone Hospitals is $509. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $796. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.77x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$796

Average discount available for prompt cash payment at this facility.

Insurance Median

$509

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: $796 (745%)

Insurance Median: $509 (477%)

Cash: $796 (745% of Medicare)

Ins. Median: $509 (477% 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 477% of the Medicare baseline (a markup of 377%). 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
Healthfirst	$66 - $737	62%
Fidelis	$94 - $737	88%
Healthplus	$94 - $737	88%
Ghi	$126 - $626	118%
Hip	$126 - $2,705	118%
Medicare (plans)	$126	118%
Wellcare	$126	118%
Centerlight	$128	120%
Hamaspik	$189	177%
1199	$241	226%
Metroplus	$249 - $737	233%
Medicaid / KanCare	$284 - $328	266%
UnitedHealthcare	$284 - $1,482	266%
Cigna	$289	271%
Somos	$298 - $442	279%
Amida	$358 - $360	335%
Aetna	$509 - $4,294	477%
Oxford	$1,066 - $1,381	998%
Magnacare	$1,068 - $2,147	1000%
Blue Cross Blue Shield	$1,223 - $1,529	1145%
Oscar	$1,833	1716%
Multiplan	$3,184 - $3,350	2981%

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 $796.
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 NYU Langone Hospitals 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.