CMS Price Transparency Data

CT scan, sinuses

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,103
Cash Discount Price: $947
vs. Medicare Baseline: 10.33x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at CHI St Lukes Health Memorial San Augustine is $1,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $947. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.33x the Medicare baseline. Located in 511 Hospital St, San Augustine, TX.

Cash / Self-Pay

$947

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,103

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: $947 (887%)

Insurance Median: $1,103 (1033%)

Cash: $947 (887% of Medicare)

Ins. Median: $1,103 (1033% 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 1033% of the Medicare baseline (a markup of 933%). 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
Aetna	$97 - $1,578	91%
Humana	$97 - $4,418	91%
Wellpoint	$100 - $207	94%
Cigna	$102 - $1,103	95%
Blue Cross Blue Shield	$106 - $447	99%
United	$106 - $6,312	99%
Scanhealth	$108	101%
Md Save	$121	113%
Superior	$132 - $207	124%
Tchp	$135	126%
Angelina County	$265	248%
Brookshire Brothers	$291	272%
PHCS	$4,292 - $5,050	4018%
Multiplan	$4,418	4136%
Galaxy	$5,681	5319%
Entrust	$6,564	6145%

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 $947.
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 CHI St Lukes Health Memorial San Augustine 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.