CMS Price Transparency Data

CT scan, sinuses

Facility: Highland District Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $610
Cash Discount Price: $1,466
vs. Medicare Baseline: 5.71x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Highland District Hospital is $610. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,466. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.71x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$1,466

Average discount available for prompt cash payment at this facility.

Insurance Median

$610

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: $1,466 (1373%)

Insurance Median: $610 (571%)

Cash: $1,466 (1373% of Medicare)

Ins. Median: $610 (571% 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 571% of the Medicare baseline (a markup of 471%). 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
Highland_County_Sheriff_Dept	$113	106%
Medicaid / KanCare	$113 - $119	106%
Blue Cross Blue Shield	$117 - $1,392	110%
Humana	$117 - $1,623	110%
Medicare (plans)	$586 - $604	549%
UnitedHealthcare	$586	549%
Aetna	$598 - $1,488	560%
Medigold	$616	577%
Immergrun_Amish	$1,466	1373%
Medben	$1,466	1373%
Central_Benefits_Commercial	$1,649	1544%
Cigna	$1,649	1544%
Medical_Mutual_Commercial	$1,667	1561%
Uhc_	$1,685	1578%

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 $1,466.
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 Highland District 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.