CMS Price Transparency Data

CT scan, sinuses

Facility: Strong Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $144
Cash Discount Price: $459
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Strong Memorial Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.35x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$459

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

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: $459 (430%)

Insurance Median: $144 (135%)

Cash: $459 (430% of Medicare)

Ins. Median: $144 (135% 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
Blue Cross Blue Shield	$114 - $358	107%
Excellus [2201]	$121	113%
Medicaid / KanCare	$121 - $182	113%
Molina Healthcare [1723], Molina Healthcare [5189]	$121	113%
Molina Healthcare [5189]	$121	113%
UnitedHealthcare	$121 - $138	113%
Martins Point [1205]	$126 - $130	118%
Medicare (plans)	$126 - $174	118%
Aetna	$139 - $536	130%
Humana	$142 - $161	133%
Mvp [2900]	$145 - $442	136%
Cigna	$258 - $480	242%
Fidelis [5155]	$267 - $273	250%

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 $459.
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 Strong Memorial Hospital 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.