CMS Price Transparency Data

CT scan, sinuses

Facility: Physicians Care Surgical Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $385
  • Cash Discount Price: $285
  • vs. Medicare Baseline: 3.60x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Physicians Care Surgical Hospital is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.60x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$285

Average discount available for prompt cash payment at this facility.

Insurance Median
$385

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: $285 (267%)
Insurance Median: $385 (360%)
Cash: $285 (267% of Medicare)
Ins. Median: $385 (360% 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 360% of the Medicare baseline (a markup of 260%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Connecticare $124 116%
Blue Cross Blue Shield $194 - $385 182%
Highmark $194 182%
Aarp $357 334%
Aetna $357 - $730 334%
Cigna $357 334%
Devon Health Services $357 334%
Gpm Health And Life Insurance Mc Supplement $357 334%
Humana $357 334%
Ibc Security 65 $357 334%
Keystone 65 Hmo $357 334%
Medicare (plans) $357 334%
Pcsh Aarp $357 334%
Personal Choice 65 $357 334%
Shenandoah Life $357 334%
Tricare $357 334%
Unified Health Services $357 334%
UnitedHealthcare $357 - $756 334%
Vibra Health Plan $357 334%
Amerihealth Administrators $385 360%
Amerihealth New Jersey Hmo $385 360%
Carefirst Administrators $385 360%
Empire Plan $385 360%
Horizon Of New Jersey $385 360%
Ibc $385 360%
Ibc - Local $385 360%
Ibc 2021 $385 360%
Ibc Local $385 360%
Independence Administrators $385 360%
Independence Bc $385 360%
Independence Federal $385 360%
Keystone Direct Pos $385 360%
Keystone Healthplan East $385 360%
Keystone Hmo $385 360%
Pcsh Ibc $385 360%
Personal Choice $385 360%
Regence Blue Shield $385 360%
Ag Administrators $730 683%
Ag Administrators Inc $730 683%
Allied Benefit Systems $730 683%
Allied Benefits Systems $730 683%
Continental Benefits $730 683%
Coventry $730 683%
Geha $730 683%
Healthez $730 683%
Lucent Health $730 683%
Marpai Health $730 683%
Meritain Health $730 683%
Premier Care Network $730 683%
Trustmark $730 683%
Allsavers $756 708%
Golden Rule Op $756 708%
Oxford Health Plan $756 708%
Oxford Life Insurance Company $756 708%
Surest $756 708%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals