CMS Price Transparency Data

CT scan, sinuses

Facility: Legacy Good Samaritan Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $214
  • Cash Discount Price: $750
  • vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Legacy Good Samaritan Medical Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $750. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.00x the Medicare baseline. Located in 1015 Nw 22Nd Avenue, W121, Portland, OR.
Cash / Self-Pay
$750

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $750 (702%)
Insurance Median: $214 (200%)
Cash: $750 (702% of Medicare)
Ins. Median: $214 (200% 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 200% of the Medicare baseline (a markup of 100%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Kaiser $116 - $232 109%
Atrio $120 112%
Aetna $122 - $157 114%
Healthnet $123 - $535 115%
Careoregon $126 118%
Ageright $128 120%
Moda $130 - $449 122%
Pacificsource $196 - $447 184%
Cigna $304 285%
Blue Cross Blue Shield $316 - $463 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Nw 22Nd Avenue, W121, Portland, OR 97210
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals