CMS Price Transparency Data

CT scan, sinuses

Facility: Sanford Vermillion Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,503
Cash Discount Price: $1,706
vs. Medicare Baseline: 14.07x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Sanford Vermillion Medical Center is $1,503. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,706. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.07x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$1,706

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,503

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: $1,706 (1597%)

Insurance Median: $1,503 (1407%)

Cash: $1,706 (1597% of Medicare)

Ins. Median: $1,503 (1407% 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 1407% of the Medicare baseline (a markup of 1307%). 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	$629	589%
Wellmark Sd	$648	607%
Ucare	$695 - $1,873	651%
Aetna	$704 - $1,853	659%
Health Partners	$704 - $1,599	659%
Medicare (plans)	$704	659%
UnitedHealthcare	$704 - $1,780	659%
Primewest	$716	670%
Sanford Health Plan	$844 - $1,132	790%
Security Health Plan	$1,173	1098%
Medica	$1,759 - $1,880	1647%
Wellmark	$1,834 - $1,855	1717%
First Choice Health Network	$1,919	1797%
Healthez	$1,919	1797%
Multiplan	$1,919	1797%

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 $1,706.
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 Vermillion 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.