CMS Price Transparency Data

CT scan, sinuses

Facility: O'Connor Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $279
  • Cash Discount Price: $373
  • vs. Medicare Baseline: 2.61x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at O'Connor Hospital is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $373. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.61x the Medicare baseline. Located in 460 Andes Road, Delhi, NY.
Cash / Self-Pay
$373

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

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: $373 (349%)
Insurance Median: $279 (261%)
Cash: $373 (349% of Medicare)
Ins. Median: $279 (261% 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 261% of the Medicare baseline (a markup of 161%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Cdphp $73 - $849 68%
Mvp $73 - $849 68%
Blue Cross Blue Shield $104 - $1,939 97%
Emblem $114 - $824 107%
UnitedHealthcare $114 - $824 107%
Aetna $122 - $2,061 114%
Fidelis $122 - $882 114%
Humana $123 - $890 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 460 Andes Road, Delhi, NY 13753
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals