CMS Price Transparency Data

CT scan, sinuses

Facility: UPMC Williamsport

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,265
Cash Discount Price: $1,591
vs. Medicare Baseline: 11.84x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at UPMC Williamsport is $1,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,591. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.84x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$1,591

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,265

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: $1,591 (1490%)

Insurance Median: $1,265 (1184%)

Cash: $1,591 (1490% of Medicare)

Ins. Median: $1,265 (1184% 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 1184% of the Medicare baseline (a markup of 1084%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$99 - $1,813	93%
Blue Cross Blue Shield	$102 - $1,242	95%
Upmc Health Plan	$103 - $1,156	96%
Aetna	$104 - $1,750	97%
Amerihealth Caritas	$104 - $147	97%
Highmark Wholecare (Prev Gateway)	$109 - $183	102%
Pa Health & Wellness	$109 - $222	102%
Geisinger	$143 - $1,776	134%
Upmc Work Partners	$590	552%
Three Rivers Provider Network	$631 - $2,386	591%
Multiplan	$652 - $2,068	610%
Coventry/First Health	$1,328 - $1,784	1243%
Wirerope Works	$1,474	1380%
Cigna	$1,816	1700%
America'S Choice	$2,121	1986%
Intergroup	$2,121	1986%

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 $1,591.
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 Williamsport 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.