CMS Price Transparency Data

CT scan, sinuses

Facility: Indiana Regional Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $120
  • Cash Discount Price: $490
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Indiana Regional Medical Center is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $490. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$490

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $490 (459%)
Insurance Median: $120 (112%)
Cash: $490 (459% of Medicare)
Ins. Median: $120 (112% 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.

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 Wholecare $74 - $120 69%
UnitedHealthcare $89 - $545 83%
Upmc Health Plan $93 - $1,098 87%
Highmark $98 - $300 92%
Amerihealth Caritas $102 - $124 95%
Geisinger Health Plan $102 - $124 95%
Ambetter / Centene $105 - $124 98%
Humana $107 - $118 100%
Aetna $109 - $334 102%
Medicare (plans) $109 - $120 102%
United Mine Workers Of America $109 - $120 102%
Tricare $119 - $1,362 111%
Cigna $120 - $279 112%
Geisinger $168 - $305 157%
Pa Health And Wellness Commercial $168 - $305 157%
Premier Comp Solutions, Llc $225 211%
Department Of Human Services And Torrance State Hospital $858 803%
Miscellaneous Commercial $1,362 1275%
Pa Workers Compensation $1,362 1275%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals