CMS Price Transparency Data

CT scan, sinuses

Facility: Sanford Usd Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $997
Cash Discount Price: $2,199
vs. Medicare Baseline: 9.33x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Sanford Usd Medical Center is $997. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,199. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.33x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.

Cash / Self-Pay

$2,199

Average discount available for prompt cash payment at this facility.

Insurance Median

$997

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: $2,199 (2059%)

Insurance Median: $997 (933%)

Cash: $2,199 (2059% of Medicare)

Ins. Median: $997 (933% 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 933% of the Medicare baseline (a markup of 833%). 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
Blue Cross Blue Shield	$49 - $138	46%
Sanford Health Plan Align	$101	95%
Ucare	$108 - $1,932	101%
Aetna	$110 - $2,103	103%
Health Partners	$110 - $1,072	103%
Medicare (plans)	$110	103%
UnitedHealthcare	$110 - $2,422	103%
Primewest	$112 - $115	105%
Sanford Health Plan	$131	123%
Security Health Plan	$1,512	1416%
Medica	$1,853 - $1,982	1735%
First Choice Health Network	$2,474	2316%
Healthez	$2,474	2316%
Multiplan	$2,474	2316%

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 $2,199.
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 Sanford Usd Medical Center 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.