CMS Price Transparency Data

CT scan, sinuses

Facility: Coteau Des Prairies Health Care System

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,418
Cash Discount Price: $2,196
vs. Medicare Baseline: 13.28x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Coteau Des Prairies Health Care System is $1,418. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,196. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.28x the Medicare baseline. Located in 205 Orchard Dr, Sisseton, SD.

Cash / Self-Pay

$2,196

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,418

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: $2,196 (2056%)

Insurance Median: $1,418 (1328%)

Cash: $2,196 (2056% of Medicare)

Ins. Median: $1,418 (1328% 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 1328% of the Medicare baseline (a markup of 1228%). 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
Humana	$725	679%
Indian Health Service	$725	679%
Medica	$725 - $1,318	679%
UnitedHealthcare	$725 - $1,517	679%
Primwest Health	$769	720%
Blue Cross Blue Shield	$1,647 - $1,691	1542%
Avera Health Plan	$2,086	1953%
Sanford Health Plan	$2,130	1994%

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 $2,196.
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 Coteau Des Prairies Health Care System 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.