CMS Price Transparency Data

CT scan, sinuses

Facility: Wooster Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,115
  • Cash Discount Price: $1,871
  • vs. Medicare Baseline: 10.44x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Wooster Community Hospital is $1,115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,871. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.44x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$1,871

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,115

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: $1,871 (1752%)
Insurance Median: $1,115 (1044%)
Cash: $1,871 (1752% of Medicare)
Ins. Median: $1,115 (1044% 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 1044% of the Medicare baseline (a markup of 944%). 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
Tricare $99 93%
Blue Cross Blue Shield $101 - $1,721 95%
Buckeye Mcare $101 95%
Caresource Mcr Adv $101 95%
Humana $101 - $1,758 95%
Med Mutual Of Oh Mcr $101 95%
Molina Mcr $101 95%
Summacare Mcr $101 95%
The Health Plan Mcr Adv $101 95%
UnitedHealthcare $101 - $1,777 95%
Valor Hp Mcr-All Plans $101 95%
Magnipower-All Plans $131 123%
Caresource Exch - All Other Plans $144 135%
Buckeye Mcaid-All Other Plans $161 151%
Caresource Mcaid $161 151%
Molina Mcaid $164 154%
Aetna $169 - $1,871 158%
Amerihealth Mcaid-All Plans $169 158%
Molina Marketplace - All Other Plans $172 161%
Clarity Health - All Plans $197 184%
Med Mutual Of Oh Exchange $695 651%
Med Mutual Of Oh Supermed $695 651%
Med Mutual Of Oh Trad-All Other Plans $695 651%
Healthsmart Complete Ppo-All Other Plans $750 702%
Aultcare/Primecare Mcr Adv $917 859%
Cigna $920 861%
Cerco-All Plans $1,309 1226%
Aultcare Wayne County $1,403 1314%
Aultcare/Primetime Exch $1,403 1314%
Rayco-All Plans $1,403 1314%
Christian Health Ministries-All Plans $1,496 1401%
Health Ohio Network Employer $1,496 1401%
Wayne County-All Plans $1,496 1401%
Healthsmart Accel $1,553 1454%
Summacare Preferred Choice $1,553 1454%
Health Ohio Network Ppo-All Other Plans $1,590 1489%
Ohio Health Choice Supp $1,590 1489%
Ohio Health Group Hlthy - All Other Plans $1,590 1489%
Health Plan Of Upper Ohio-All Plans $1,648 1543%
The Health Plan Comm - All Other Plans $1,648 1543%
Ohio Health Group Pref $1,665 1559%
Aultcare/Primetime-All Other Plans $1,684 1577%
Healthsmart Ppo $1,702 1593%
Summacare-All Other Plans $1,740 1629%
Ohio Health Choice-All Other Plans $1,758 1646%
Healthsmart Hpo $1,777 1664%
Osu-All Plans $1,777 1664%
Central Benefits-All Plans $1,796 1681%
First Health-All Plans $1,796 1681%
Flora-All Plans $1,796 1681%
Beech Street-All Plans $1,814 1698%
Phcs-All Plans $1,814 1698%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals