CMS Price Transparency Data

CT scan, sinuses

Facility: UPMC Somerset

Billing Code: 70486 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$139

about 1.3× the $107 Medicare rate · typically $118–$158

modeled estimate · not a bill or quote

What this hospital charges insurers

$149

About the fair price

about $10 over the fair price · 1.4× Medicare

Medicare pays $107 Fair price $139 This hospital $149 Cash price $797 Hospital's list price $1,328

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $88 Priciest $149

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a CT scan, sinuses is about $139 (about 1.3× the $107 Medicare rate). UPMC Somerset charges insurers about $149, or about $797 in cash — about the fair price. Located in Somerset, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$89 - $572	83%
Blue Cross Blue Shieldmajor	$100 - $269	94%
Aetnamajor	$531	497%
Humanamajor	$996	932%
AmeriHealth	$101 - $149	95%
Geisinger	$181 - $523	169%
UPMC Health Plan	$101 - $849	95%

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 797), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 70486.

Insurance Before you use insurance

Call your insurance company to confirm UPMC Somerset is in-network.
Ask your insurer whether prior approval is required for CPT code 70486.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at UPMC Somerset

Compare: CT scan, sinuses at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.