CMS Price Transparency Data

CT scan, sinuses

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $195
  • Cash Discount Price: $532
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Cincinnati Children's Hospital Medical Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.83x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$532

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $532 (498%)
Insurance Median: $195 (183%)
Cash: $532 (498% of Medicare)
Ins. Median: $195 (183% 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.

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
Blue Cross Blue Shield $27 - $1,822 25%
Caresource_In $28 - $142 26%
Mhs_In $28 - $135 26%
Aetna $37 - $1,760 35%
Humana $38 - $463 36%
Passport_Ky $38 - $482 36%
Wellcare_Ky $38 - $487 36%
United_Health_Care_Ky $39 - $489 37%
Caresource_Oh $63 - $274 59%
Amerihealth_Caritas_Oh $65 - $296 61%
Molina_Oh $66 - $302 62%
Buckeye_Oh $70 - $315 66%
United_Health_Care_Oh $76 - $289 71%
Caresource_Oh_Insurance $112 - $889 105%
Medical_Mutual_Of_Ohio_Insurance $125 - $1,760 117%
Parkview_Signature_Care_Insurance $143 - $1,445 134%
Point_Comfort_Insurance $151 - $1,204 141%
Margaret_Mary_Health_Insurance $154 - $1,445 144%
United_Health_Care_Insurance $177 - $1,660 166%
Beechstreet_Insurance $188 - $1,816 176%
Cigna $188 - $1,760 176%
Health_Ohio_Network_Insurance $212 - $1,760 198%
Custom_Design_Benefits_Insurance $221 - $1,760 207%
Health_Smart_Preferred_Insurance $221 - $1,760 207%
Medical_Benefit_Administrators_Insurance $221 - $1,760 207%
Ohio_Health_Choice_Insurance $221 - $1,760 207%
Private_Health_Care_Systems_Insurance $224 - $1,779 210%
First_Health_Group_Insurance $228 - $1,816 213%
Health_Link_Insurance $228 - $1,816 213%
Evolutions_Health_Care_Systems $233 - $1,853 218%
Galaxy_Health_Insurance $233 - $1,853 218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens