CMS Price Transparency Data

CT scan, sinuses

Facility: University Hospitals - Elyria Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $836
  • Cash Discount Price: $1,253
  • vs. Medicare Baseline: 7.83x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at University Hospitals - Elyria Medical Center is $836. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,253. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.83x the Medicare baseline. Located in 630 East River Street, Elyria, OH.
Cash / Self-Pay
$1,253

Average discount available for prompt cash payment at this facility.

Insurance Median
$836

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: $1,253 (1173%)
Insurance Median: $836 (783%)
Cash: $1,253 (1173% of Medicare)
Ins. Median: $836 (783% 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 783% of the Medicare baseline (a markup of 683%). 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
Aetna $99 - $1,843 93%
Blue Cross Blue Shield $99 - $729 93%
Cigna $99 - $936 93%
Devoted Health $99 93%
Humana $99 93%
Medical Mutual Of Ohio $99 - $819 93%
Molina $99 93%
Primetime Health Plan $99 93%
Summacare $99 - $1,200 93%
The Health Plan $99 - $1,103 93%
UnitedHealthcare $99 - $1,380 93%
Wellcare By Allwell $99 93%
Paramount $102 95%
Perennial Advantage Of Ohio $104 97%
Valor Health Plans $104 97%
Ambetter / Centene $177 166%
Caresource $177 166%
University Health Employee Plan (Contigo) $520 487%
Amish Aid Community Plan $600 562%
Amish Church Fund And Workers Aid Plan $600 562%
Buckeye Plain Ministries $600 562%
Clarity $802 751%
Christian Healthcare Ministries $836 - $900 783%
Immergrun $836 783%
Sunrise Plan Communities $836 783%
Aultcare $975 913%
Healthsmart $1,086 1017%
Ohio Health Choice $1,086 - $1,504 1017%
Medical Mutual Traditional/Health Ohio $1,170 1095%
Beech Street $1,337 - $1,504 1252%
Ohio Preferred Network $1,337 - $1,504 1252%
First Health $1,387 1299%
Century Health Network $1,420 1329%
Private Healthcare System $1,437 1345%
Configurenet $1,504 1408%
Fortified Provider Network $1,504 1408%
Multiplan $1,504 1408%
Jp Farley $1,595 1493%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 630 East River Street, Elyria, OH 44035
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals