CMS Price Transparency Data

CT scan, sinuses

Facility: Ascension Seton Hays

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $112
Cash Discount Price: $1,069
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Ascension Seton Hays is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,069. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.

Cash / Self-Pay

$1,069

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $1,069 (1001%)

Insurance Median: $112 (105%)

Cash: $1,069 (1001% of Medicare)

Ins. Median: $112 (105% 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.

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
Champva	$100 - $134	94%
Aarp Mc Wellmed	$101	95%
Sendero Chap	$102	95%
Addr Cancer Together	$103	96%
Aetna	$103 - $1,345	96%
Covid Hrsa	$103	96%
Cshcn Cidc	$103	96%
Devoted Health Mcr Replacement	$103	96%
Humana	$103 - $172	96%
Medicare (plans)	$103	96%
Research Study	$103	96%
Smarthealth	$103	96%
Superior Allwell	$103	96%
Tricare	$103 - $109	96%
Utmb	$103	96%
Wellcare Med Advantage	$103	96%
UnitedHealthcare	$105 - $114	98%
Connected Senior Care	$106	99%
Ambetter / Centene	$107 - $185	100%
Blue Cross Blue Shield	$107 - $501	100%
Dell Chip/Chip Perinate	$107 - $114	100%
Wellpoint Chip/Chip Perinate	$107 - $112	100%
Wellpoint Star Kids	$107	100%
Wellpoint Star Plus	$107 - $114	100%
Pphp Mcr Advantage	$108	101%
Tx Independence Hp	$108	101%
Dell Star	$112 - $114	105%
Wellpoint Star	$112 - $114	105%
Occunet	$144	135%
Sendero Idealcare	$180	169%
Seton Performance Plus	$317	297%
Superior Star	$792 - $1,436	742%
Superior Star Foster	$792 - $1,436	742%
Superior Star Kids	$792 - $1,436	742%
Superior Star Plus	$792 - $1,436	742%
Superior Chip/Chip Perinate	$891 - $1,615	834%
Covenant Health	$940	880%
Cigna	$1,610	1507%

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 $1,069.
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 Ascension Seton Hays 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.