CMS Price Transparency Data
CT scan, sinuses
Facility: Hospital of Univ of Pennsylvania
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $206
- Cash Discount Price: $2,248
- vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Hospital of Univ of Pennsylvania is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,248. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.93x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$2,248
Average discount available for prompt cash payment at this facility.
Insurance Median
$206
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: $2,248 (2105%)
Insurance Median: $206 (193%)
Cash: $2,248 (2105% of Medicare)
Ins. Median: $206 (193% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Horizon Nj Health | $35 - $754 | 33% |
| Preferred Health Care Eliance | $45 - $944 | 42% |
| Pgm - Regie De L'Assurance Maladie Quebec | $47 - $987 | 44% |
| Gspp And Wissahickon Hospice | $55 | 51% |
| Pgm - Kuwait Defense | $72 - $1,930 | 67% |
| Medicaid / KanCare | $78 - $4,290 | 73% |
| Qualcare | $78 - $1,630 | 73% |
| Kaiser Permanente | $81 - $4,290 | 76% |
| Olympus | $81 - $1,686 | 76% |
| Coventry | $82 - $2,188 | 77% |
| Pgm - Chop | $82 - $1,716 | 77% |
| Wissahickon Hospice | $82 - $1,716 | 77% |
| Cigna | $93 - $1,930 | 87% |
| Healthamerica/Coventry | $93 - $2,102 | 87% |
| UnitedHealthcare | $97 - $4,290 | 91% |
| Keystone Mercy Health Plan | $99 - $4,290 | 93% |
| First Health Global | $103 - $2,145 | 96% |
| Blue Cross Blue Shield | $110 - $3,224 | 103% |
| Medicare (plans) | $110 - $112 | 103% |
| Philadelphia Va Medical Center | $110 | 103% |
| Tricare | $110 | 103% |
| Upmc | $110 - $4,290 | 103% |
| Ibc | $112 | 105% |
| Geisinger Health Plan | $113 - $349 | 106% |
| Health Partners | $113 - $4,290 | 106% |
| Humana | $113 - $3,432 | 106% |
| Devoted Health | $115 | 108% |
| Pa Health And Wellness | $115 - $181 | 108% |
| Penn Life (Living Independently For Elders) | $115 | 108% |
| Aetna | $116 - $4,290 | 109% |
| Clover Health Plan | $119 | 111% |
| Keystone First | $122 | 114% |
| Health Net | $124 - $2,574 | 116% |
| Pgm - Royal Embassy Of Saudi Arabia | $124 - $2,574 | 116% |
| Us Family Health Plan | $126 | 118% |
| Paired Kidney Exchange | $129 | 121% |
| Pa Medical Assistance | $130 - $4,290 | 122% |
| Pgm - Embassy Of Qatar | $134 - $2,788 | 125% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $134 - $2,788 | 125% |
| Gateway Health Plan | $136 | 127% |
| Interlink | $138 - $2,874 | 129% |
| Pgm - Embassy Of The United Emirates/Ipc | $144 - $3,003 | 135% |
| Elap | $156 | 146% |
| Health America/Ccn | $165 - $3,432 | 154% |
| Intergroup | $165 - $3,432 | 154% |
| Pgm - Kuwait Health Division | $165 - $3,432 | 154% |
| Pgm - Kuwait Oil | $165 - $3,432 | 154% |
| Preferred Care | $165 - $3,432 | 154% |
| Claims Watcher | $176 - $198 | 165% |
| Oscar Health Plan | $187 | 175% |
| Centivo | $198 | 185% |
| Elap Services | $204 | 191% |
| Blue Quality Centers For Transplant (Bqct) | $206 - $4,290 | 193% |
| City Of Philadelphia Behavioral Health | $206 - $4,290 | 193% |
| Commercial Other | $206 - $4,290 | 193% |
| Ibc Commercial Hpn | $206 - $264 | 193% |
| International Pfs | $206 - $4,290 | 193% |
| Keystone Hmo Proactive | $206 - $256 | 193% |
| United Behavioral Health | $206 - $4,290 | 193% |
| Workers Compensation | $206 - $4,290 | 193% |
| Highmark | $231 | 216% |
| Penn Global Medicine | $291 | 272% |