CMS Price Transparency Data

CT scan, sinuses

Facility: St Christopher's Hospital for Children

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $802
  • Cash Discount Price: $3,159
  • vs. Medicare Baseline: 7.51x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at St Christopher's Hospital for Children is $802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,159. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.51x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.
Cash / Self-Pay
$3,159

Average discount available for prompt cash payment at this facility.

Insurance Median
$802

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: $3,159 (2958%)
Insurance Median: $802 (751%)
Cash: $3,159 (2958% of Medicare)
Ins. Median: $802 (751% 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 751% of the Medicare baseline (a markup of 651%). 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
Geisinger $95 - $2,843 89%
Amerihealth Caritas $97 91%
Pa Health & Wellness $105 98%
UnitedHealthcare $116 - $168 109%
Aetna $136 - $4,738 127%
Health Partners $136 - $1,418 127%
Upmc $140 131%
Keystone First $146 137%
Gateway $172 161%
Cigna $217 203%
Horizon Nj Health $280 262%
Blue Cross Blue Shield $415 - $3,426 389%
Wellpoint Nj (Formerly Amerigroup) $1,674 1567%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 160 East Erie Ave, Philadelphia, PA 19134
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Childrens