CMS Price Transparency Data

CT scan, sinuses

Facility: St David's Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $291
  • Cash Discount Price: $1,375
  • vs. Medicare Baseline: 2.72x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at St David's Medical Center is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,375. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.72x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$1,375

Average discount available for prompt cash payment at this facility.

Insurance Median
$291

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: $1,375 (1287%)
Insurance Median: $291 (272%)
Cash: $1,375 (1287% of Medicare)
Ins. Median: $291 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Superior Health Plan $19 - $404 18%
United $94 - $1,068 88%
St David’S Hospice $105 98%
Blue Cross Blue Shield $110 - $757 103%
Imo Med - Select Network $113 - $712 106%
Molina Healthcare $115 108%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $2,612 124%
Texas Healthcare Foundation Heb $139 - $878 130%
Texas Workforce Commission $147 - $926 138%
Averde Health $169 - $1,068 158%
Amerigroup $183 171%
Comanche County $188 - $1,187 176%
National Choicecare $188 - $1,187 176%
Healthsmart Preferred Care $207 - $1,899 194%
Independent Medical Systems $207 - $1,306 194%
Physicians Cooperative Of Texas $207 - $1,306 194%
Prime Health $226 - $1,424 212%
First Health $237 - $1,707 222%
Coastal Comp Health Networks $244 - $1,543 228%
National Health Care $244 - $1,543 228%
Texas Municipal League $263 - $1,662 246%
Medcorp Southwest $282 - $1,780 264%
Rockport Healthcare Group $301 - $2,137 282%
Bce Emergis Corporation $338 - $2,137 316%
Beech Street $338 - $2,137 316%
Medical Control Network Solutions $338 - $2,137 316%
Multiplan $338 - $2,137 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals