CMS Price Transparency Data

CT scan, sinuses

Facility: UPMC Muncy

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,402
Cash Discount Price: $1,591
vs. Medicare Baseline: 13.13x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at UPMC Muncy is $1,402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,591. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.13x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$1,591

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,402

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: $1,591 (1490%)

Insurance Median: $1,402 (1313%)

Cash: $1,591 (1490% of Medicare)

Ins. Median: $1,402 (1313% 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 1313% of the Medicare baseline (a markup of 1213%). 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
UnitedHealthcare	$99 - $1,813	93%
Geisinger	$143 - $1,776	134%
Upmc Health Plan	$143 - $1,156	134%
Highmark Wholecare (Prev Gateway)	$145 - $398	136%
Amerihealth Caritas	$147 - $2,208	138%
Pa Health & Wellness	$222 - $2,316	208%
Cigna	$418 - $1,816	391%
Upmc Work Partners	$590	552%
Three Rivers Provider Network	$631 - $2,386	591%
Blue Cross Blue Shield	$1,040 - $1,224	974%
Aetna	$1,075 - $1,750	1006%
Coventry/First Health	$1,328 - $1,784	1243%
Wirerope Works	$1,474	1380%
Multiplan	$2,068 - $2,518	1936%
America'S Choice	$2,121	1986%
Intergroup	$2,121	1986%

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 $1,591.
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 Muncy 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.