CMS Price Transparency Data

CT scan, sinuses

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $210
Cash Discount Price: $1,916
vs. Medicare Baseline: 1.97x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Nationwide Children's Hospital Toledo, LLC is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,916. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.97x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$1,916

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

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: $1,916 (1794%)

Insurance Median: $210 (197%)

Cash: $1,916 (1794% of Medicare)

Ins. Median: $210 (197% 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.

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
Caresource	$39 - $112	37%
Paramount	$39	37%
Blue Cross Blue Shield	$41 - $1,629	38%
Front Path Health Coalition	$51 - $1,437	48%
Mcclaren Health Plan	$54 - $1,437	51%
Aetna	$96 - $1,230	90%
Molina	$107 - $208	100%
Mcclaren Health Plan - Michigan	$110	103%
Cigna	$127 - $388	119%
UnitedHealthcare	$130 - $1,613	122%
Amerihealth	$210	197%
Bchp	$210	197%
Humana	$210	197%
Ohc	$244 - $1,597	228%
Ohio Ppo Connect	$244 - $1,597	228%
Mmo	$798 - $1,118	747%
First Health	$2,459	2302%

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 $1,916.
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 Nationwide Children's Hospital Toledo, LLC 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.