CMS Price Transparency Data

CT scan, sinuses

Facility: Elizabethtown Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $189
Cash Discount Price: $1,241
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Elizabethtown Community Hospital is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,241. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.77x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$1,241

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $1,241 (1162%)

Insurance Median: $189 (177%)

Cash: $1,241 (1162% of Medicare)

Ins. Median: $189 (177% 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
Capital District Physicians' Health Plan	$82 - $1,942	77%
UnitedHealthcare	$85 - $2,175	80%
Harvard Pilgrim	$95 - $1,890	89%
Magnacare	$95 - $1,890	89%
Coventry	$101 - $2,008	95%
Humana	$101 - $115	95%
Fidelis Care	$103 - $898	96%
Mvp	$103 - $1,845	96%
Multiplan	$107 - $2,126	100%
Blue Cross Blue Shield	$109 - $1,775	102%
Aetna	$121 - $1,772	113%
Martins Point	$121 - $898	113%
Veterans Affairs Community Care Network	$121 - $898	113%
Choicecare	$133 - $1,890	125%
Highmark Blueshield	$152 - $1,925	142%
Wellpath	$169 - $1,346	158%
Emblem Health	$1,890	1769%

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 $1,241.
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 Elizabethtown Community 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.