CMS Price Transparency Data

CT scan, sinuses

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $137
Cash Discount Price: $146
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Independence Health System Butler Memorial Hospita is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.28x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $146 (137%)

Insurance Median: $137 (128%)

Cash: $146 (137% of Medicare)

Ins. Median: $137 (128% 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
Highmark	$24 - $290	22%
Highmark - Ind.& Managed Care	$24 - $290	22%
Highmark Aca - Direct Blue	$24 - $290	22%
Highmark Community Blue	$24 - $290	22%
Ellwood Group	$39 - $666	37%
Martin'S Point - Usfhp	$46 - $542	43%
Upmc	$46 - $1,628	43%
Devoted Health Plan	$52 - $620	49%
Aetna	$65 - $1,240	61%
Ccbh - Behavioral Health	$65 - $775	61%
Cigna	$65 - $775	61%
Peak Health	$91 - $1,085	85%
Private Healthcare Systems	$91 - $1,318	85%
Devon	$98 - $1,162	92%
Pnoa	$98 - $1,240	92%
Life Butler County	$102	95%
Medicare (plans)	$102	95%
Provider Partners	$102	95%
Tricare	$102	95%
UnitedHealthcare	$102 - $262	95%
Intergroup	$104 - $1,240	97%
Humana	$106	99%
Amerihealth	$107 - $143	100%
Geisinger	$107 - $1,550	100%
The Health Plan	$108 - $240	101%
Pa Health & Wellness	$109	102%
American Health Plan	$113	106%
Workers Comp	$113	106%
Gateway	$115 - $1,628	108%
Multiplan	$117 - $1,395	110%
Medicaid / KanCare	$130	122%
Jefferson Health Plan	$143	134%

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 $146.
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 Independence Health System Butler Memorial Hospita 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.