CMS Price Transparency Data

CT scan, sinuses

Facility: UPMC Altoona

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $848
Cash Discount Price: $1,017
vs. Medicare Baseline: 7.94x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at UPMC Altoona is $848. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,017. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.94x the Medicare baseline. Located in 620 Howard Avenue, Altoona, PA.

Cash / Self-Pay

$1,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$848

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: $1,017 (952%)

Insurance Median: $848 (794%)

Cash: $1,017 (952% of Medicare)

Ins. Median: $848 (794% 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 794% of the Medicare baseline (a markup of 694%). 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
Aetna	$78 - $898	73%
UnitedHealthcare	$81 - $869	76%
Upmc Health Plan	$85 - $925	80%
Geisinger	$108 - $932	101%
Highmark Wholecare (Prev Gateway)	$115 - $848	108%
Health Partners Plans (Jefferson Health Plan)	$117	110%
Amerihealth Caritas	$121	113%
Pa Health & Wellness	$132	124%
Upmc Work Partners	$240	225%
Blue Cross Blue Shield	$272	255%
Cigna	$848	794%
Preferred Healthcare System	$848	794%
Private Health Care Systems	$1,356	1270%

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 $1,017.
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 Altoona 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.