CMS Price Transparency Data

CT scan, sinuses

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,502
Cash Discount Price: $1,618
vs. Medicare Baseline: 14.06x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Sanford Canton-Inwood Medical Center - Cah is $1,502. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,618. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.06x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.

Cash / Self-Pay

$1,618

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,502

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: $1,618 (1515%)

Insurance Median: $1,502 (1406%)

Cash: $1,618 (1515% of Medicare)

Ins. Median: $1,502 (1406% 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 1406% of the Medicare baseline (a markup of 1306%). 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
Sanford Health Plan Align	$692	648%
Ucare	$742 - $1,777	695%
Wellmark	$742 - $1,760	695%
Aetna	$751 - $1,758	703%
Health Partners	$751 - $1,517	703%
Medicare (plans)	$751	703%
UnitedHealthcare	$751 - $1,689	703%
Primewest	$765	716%
Sanford Health Plan	$1,108 - $1,487	1037%
Security Health Plan	$1,113	1042%
Medica	$1,669 - $1,784	1563%
First Choice Health Network	$1,821	1705%
Healthez	$1,821	1705%
Multiplan	$1,821	1705%

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 $1,618.
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 Canton-Inwood Medical Center - Cah 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.