CMS Price Transparency Data

CT scan, sinuses

Facility: Ira Davenport Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,337
Cash Discount Price: $1,470
vs. Medicare Baseline: 12.52x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Ira Davenport Memorial Hospital is $1,337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,470. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.52x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$1,470

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,337

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: $1,470 (1376%)

Insurance Median: $1,337 (1252%)

Cash: $1,470 (1376% of Medicare)

Ins. Median: $1,337 (1252% 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 1252% of the Medicare baseline (a markup of 1152%). 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
Empire	$31 - $117	29%
Blue Cross Blue Shield	$112 - $7,373	105%
Fidelis	$112	105%
Humana	$126 - $2,187	118%
Tricare	$126	118%
Amerihealth Caritas Mcr Adv - All Plans	$127	119%
UnitedHealthcare	$1,217 - $2,552	1139%
Fidelis Care - Exchange - All Plans	$1,337	1252%
Geisinger - All Plans	$1,414	1324%
Cigna	$1,514	1417%
Mvp Health Plan - All Plans	$1,514	1417%
Independent Health - All Plans	$1,580	1479%
Upmc - All Plans	$1,677	1570%
Pomco Inc - All Plans	$1,750	1638%
Aetna	$1,823 - $2,169	1707%
Emblem Health - All Plans	$2,139	2003%
Emblem/Ghi	$2,246	2103%
Martins Point - All Plans	$2,430	2275%
Healthnow - All Plans	$8,005	7495%

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 $1,470.
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 Ira Davenport 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.