CMS Price Transparency Data

CT scan, sinuses

Facility: Fostoria Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,141
Cash Discount Price: $1,426
vs. Medicare Baseline: 10.68x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Fostoria Community Hospital is $1,141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,426. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.68x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$1,426

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,141

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: $1,426 (1335%)

Insurance Median: $1,141 (1068%)

Cash: $1,426 (1335% of Medicare)

Ins. Median: $1,141 (1068% 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 1068% of the Medicare baseline (a markup of 968%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Meridian Health Plan Of Mi	$57	53%
Paramount Health Care	$115 - $1,163	108%
Blue Cross Blue Shield	$118 - $1,422	110%
Health Alliance Plan	$118 - $1,646	110%
Health Value Management	$118 - $475	110%
Buckeye Community Health Plan	$121 - $489	113%
Buckeye Community Health Plan Inc	$134 - $796	125%
Aetna	$135 - $1,470	126%
Dayton Area Health Plan Dba Caresource	$186 - $911	174%
UnitedHealthcare	$270 - $1,312	253%
Amerihealth	$283	265%
Veterans Affairs	$483	452%
Medical Mutual Of Ohio	$1,240 - $1,319	1161%
Frontpath Health Coalition	$1,264	1183%
Ohio Health Choice	$1,426	1335%
Ohio Ppo Connect	$1,426 - $1,646	1335%
Health Ohio Network	$1,733	1623%
Connecticut General Life Insurance Company	$1,751	1639%

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 $1,426.
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 Fostoria 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.