CMS Price Transparency Data

CT scan, sinuses

Facility: Montefiore St Luke's Cornwall

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $154
Cash Discount Price: $131
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Montefiore St Luke's Cornwall is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.44x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $131 (123%)

Insurance Median: $154 (144%)

Cash: $131 (123% of Medicare)

Ins. Median: $154 (144% 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.

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
Fidelis	$104 - $151	97%
Affinity	$121 - $137	113%
Emblem	$121 - $1,711	113%
Healthfirst	$121 - $672	113%
Medicaid / KanCare	$121	113%
Mediblue	$127	119%
Aetna	$129 - $182	121%
Blue Cross Blue Shield	$130 - $1,159	122%
Cdphp	$130	122%
Hudson Valley	$130	122%
Oscar	$130 - $206	122%
Point Comfort	$130	122%
UnitedHealthcare	$130 - $174	122%
Villagecaremax	$130	122%
Vnsny Choice	$130	122%
Centerlight	$134	125%
Wellcare	$134	125%
Hamaspik	$141	132%
Humana	$144	135%
American Postal Workers	$174	163%
Geha	$182	170%
Meritain Health	$182	170%
Nippon Life Insurance	$182	170%
Mvp	$339	317%
Northwell	$351	329%
Centivo	$1,348	1262%
Seiu1199	$1,604	1502%
Cigna	$1,911 - $2,124	1789%

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 $131.
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 Montefiore St Luke's Cornwall 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.