CMS Price Transparency Data

CT scan, sinuses

Facility: UPMC Jameson

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $175
Cash Discount Price: $616
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at UPMC Jameson is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.64x the Medicare baseline. Located in 1211 Wilmington Avenue, New Castle, PA.

Cash / Self-Pay

$616

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $616 (577%)

Insurance Median: $175 (164%)

Cash: $616 (577% of Medicare)

Ins. Median: $175 (164% 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
UnitedHealthcare	$89 - $763	83%
Aetna	$101 - $147	95%
Humana	$101 - $822	95%
Upmc Health Plan	$106 - $849	99%
Amerihealth Caritas	$109 - $169	102%
Cigna	$109 - $670	102%
Highmark Wholecare (Prev Gateway)	$109 - $514	102%
Pa Health & Wellness	$109 - $222	102%
Occunet	$127	119%
Geisinger	$181	169%
Blue Cross Blue Shield	$276	258%
Upmc Work Partners	$556	521%
Multiplan	$770 - $822	721%
National Provider Network	$904	846%

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 $616.
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 UPMC Jameson 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.