CMS Price Transparency Data
CT scan, sinuses
Facility: Mount Carmel Dublin
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $638
- Cash Discount Price: $888
- vs. Medicare Baseline: 5.97x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mount Carmel Dublin is $638. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $888. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.97x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.
Cash / Self-Pay
$888
Average discount available for prompt cash payment at this facility.
Insurance Median
$638
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: $888 (831%)
Insurance Median: $638 (597%)
Cash: $888 (831% of Medicare)
Ins. Median: $638 (597% 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 597% of the Medicare baseline (a markup of 497%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $89 - $106 | 83% |
| Aetna | $99 - $1,385 | 93% |
| Blue Cross Blue Shield | $99 - $1,366 | 93% |
| Oscar | $101 | 95% |
| UnitedHealthcare | $101 - $1,182 | 95% |
| The Health Plan | $103 | 96% |
| Enterprise Group Planning | $195 | 183% |
| Custom Design Benefits | $211 | 198% |
| Quality Care Partners | $228 | 213% |
| Medical Mutual | $248 - $342 | 232% |
| Western & Southern Financial Group | $342 | 320% |
| Geha | $613 - $1,182 | 574% |
| Gravie Admin Services | $613 | 574% |
| Healthez | $613 | 574% |
| Meritain | $613 | 574% |
| Webtpa | $613 | 574% |
| Access Health | $638 | 597% |
| Acclaim | $638 | 597% |
| Administrative Concepts | $638 | 597% |
| Allegeant | $638 | 597% |
| Allied Benefit Systems | $638 | 597% |
| American Family | $638 | 597% |
| American Healthcare Alliance | $638 | 597% |
| American National | $638 | 597% |
| American Republic | $638 | 597% |
| Amerihealth | $638 | 597% |
| Aultcare | $638 | 597% |
| Automated Benefit Services | $638 | 597% |
| Auxiant | $638 | 597% |
| Benefit Administrative Systems,Llc | $638 | 597% |
| Boon Chapman | $638 | 597% |
| Cam Administrative Services | $638 | 597% |
| Christian Brother Services | $638 | 597% |
| Christian Brothers Holy Cross | $638 | 597% |
| Claimchoice Adminstrators | $638 | 597% |
| Comprehensive Benefits | $638 | 597% |
| Continental Life Insurance | $638 | 597% |
| Coventry | $638 | 597% |
| Custom Benefit Administrators | $638 | 597% |
| Cypress Benefit Administrators | $638 | 597% |
| Employee Benefit Concepts | $638 | 597% |
| Employee Benefit Management | $638 | 597% |
| Forest County Potawatomi | $638 | 597% |
| Freedom Life Insurance Company | $638 | 597% |
| Group Administrators | $638 | 597% |
| Group Marketing Services | $638 | 597% |
| Group Pension Administrators | $638 | 597% |
| Guardian | $638 | 597% |
| Health America | $638 | 597% |
| Health Choices | $638 | 597% |
| Healthcare Management Admin | $638 | 597% |
| Insight | $638 | 597% |
| Intercare | $638 | 597% |
| Jfp Benefit Management | $638 | 597% |
| Jp Farley Corporation | $638 | 597% |
| Key Benefit Administrator | $638 | 597% |
| Liberty Union Life Assurance Co | $638 | 597% |
| Lucent Health | $638 | 597% |
| Luminare Health | $638 | 597% |
| Magnacare | $638 | 597% |
| Medcost | $638 | 597% |
| Mutual Health Services | $638 | 597% |
| Mutual Of Omaha | $638 | 597% |
| Ncas | $638 | 597% |
| Nippon Life Ins | $638 | 597% |
| Nova | $638 | 597% |
| Painters Union Insurance Fund | $638 | 597% |
| Physicians Mutual | $638 | 597% |
| Plumbers Local 98 Insurance Fund | $638 | 597% |
| Prairie States | $638 | 597% |
| Preferred One | $638 | 597% |
| Primary Physician Care | $638 | 597% |
| Professional Benefit Administrators | $638 | 597% |
| Secureone Preferred United Plans | $638 | 597% |
| Siho Insurance Services | $638 | 597% |
| Sisco Benefits | $638 | 597% |
| The Loomis Company | $638 | 597% |
| Trustmark Small Business Benefits | $638 | 597% |
| U Of M Health Plan | $638 | 597% |
| Unicare | $638 | 597% |
| Unified Group Services | $638 | 597% |
| Us Health And Life | $638 | 597% |
| Valenz | $638 | 597% |
| Varipro | $638 | 597% |
| Wps | $638 | 597% |
| Humana | $698 - $1,366 | 653% |
| First Health | $720 | 674% |
| Paramount Hmo | $720 | 674% |
| Medben | $820 - $1,024 | 768% |
| Consociate | $835 | 782% |
| Health Ohio Network | $835 | 782% |
| Healthlink Inc | $1,024 | 959% |
| Medical Benefits Mutual | $1,024 | 959% |
| Ohio Health Choice | $1,024 | 959% |
| Ohio Ppo Connect | $1,024 | 959% |
| Medi Share | $1,091 | 1021% |
| Multiplan | $1,091 | 1021% |
| Phcs | $1,091 | 1021% |
| Philadelphia American Life Insurance | $1,091 | 1021% |
| Ameriben | $1,093 | 1023% |
| Luminare Health (Detroit) | $1,093 | 1023% |
| Ohiohealthy | $1,093 | 1023% |
| Osu Not Independent Choice | $1,093 | 1023% |
| Twin Valley Psychiatric | $1,093 | 1023% |
| American Postal Workers Secondary | $1,126 | 1054% |
| Cigna | $1,126 | 1054% |
| Health Partners | $1,126 | 1054% |
| Healthgram | $1,126 | 1054% |
| Mvp | $1,126 | 1054% |
| Priority Health | $1,126 | 1054% |
| Health Smart | $1,161 | 1087% |
| Medicaid / KanCare | $1,366 | 1279% |
| Rural Carrier Health Benefit Plan | $1,370 | 1283% |