CMS Price Transparency Data

CT scan, sinuses

Facility: St David's South Austin Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,485
  • Cash Discount Price: $5,995
  • vs. Medicare Baseline: 23.27x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at St David's South Austin Medical Center is $2,485. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,995. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.27x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$5,995

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,485

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: $5,995 (5613%)
Insurance Median: $2,485 (2327%)
Cash: $5,995 (5613% of Medicare)
Ins. Median: $2,485 (2327% 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 2327% of the Medicare baseline (a markup of 2227%). 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
St David’S Hospice $105 98%
United $109 - $2,751 102%
Blue Cross Blue Shield $110 - $1,950 103%
Molina Healthcare $115 108%
Humana $131 123%
Sendero $131 123%
Aetna $132 - $2,612 124%
Amerigroup $183 171%
Superior Health Plan $294 - $1,039 275%
Cigna $1,704 - $1,773 1595%
Imo Med - Select Network $1,763 - $1,834 1651%
Texas Healthcare Foundation Heb $2,174 - $2,262 2035%
Texas Workforce Commission $2,292 - $2,384 2146%
Averde Health $2,645 - $2,751 2476%
Comanche County $2,938 - $3,056 2751%
Emerging Therapy Solutions $2,938 - $4,218 2751%
National Choicecare $2,938 - $3,056 2751%
Healthsmart Preferred Care $3,232 - $4,890 3026%
Independent Medical Systems $3,232 - $3,362 3026%
Physicians Cooperative Of Texas $3,232 - $3,362 3026%
Prime Health $3,526 - $3,668 3301%
First Health $3,703 - $4,395 3467%
Coastal Comp Health Networks $3,820 - $3,973 3576%
National Health Care $3,820 - $3,973 3576%
Texas Municipal League $4,114 - $4,279 3852%
Medcorp Southwest $4,408 - $4,585 4127%
Preferred Health Arrangement $4,408 - $4,585 4127%
Rockport Healthcare Group $4,702 - $5,502 4402%
Bce Emergis Corporation $5,289 - $5,502 4952%
Beech Street $5,289 - $5,502 4952%
Medical Control Network Solutions $5,289 - $5,502 4952%
Multiplan $5,289 - $5,502 4952%
UnitedHealthcare $5,877 - $6,113 5502%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals