CMS Price Transparency Data

CT scan, sinuses

Facility: Uva Health Culpeper Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $507
Cash Discount Price: $1,050
vs. Medicare Baseline: 4.75x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Uva Health Culpeper Medical Center is $507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,050. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.75x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$1,050

Average discount available for prompt cash payment at this facility.

Insurance Median

$507

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: $1,050 (983%)

Insurance Median: $507 (475%)

Cash: $1,050 (983% of Medicare)

Ins. Median: $507 (475% 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 475% of the Medicare baseline (a markup of 375%). 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
Champva [50002]	$92 - $94	86%
Tricare	$92 - $94	86%
Blue Ridge Pace [10510]	$94	88%
Medicaid / KanCare	$94	88%
Aetna	$105 - $2,015	98%
Blue Cross Blue Shield	$105 - $313	98%
Cigna	$105 - $1,340	98%
HMO Part B [10099]	$105	98%
Humana	$105 - $110	98%
Medicare (plans)	$105 - $108	98%
UnitedHealthcare	$105 - $5,134	98%
VA Ccn [99926]	$105 - $108	98%
VA Ccn [99927]	$105 - $108	98%
Veterans Administration [99910]	$108	101%
Carefirst [30007]	$610 - $742	571%
Beacon Health Options [40012]	$1,076	1007%
Commercial Contracted Hb Only [40056]	$1,129	1057%
Commercial Generic [40000]	$1,129 - $1,506	1057%
Commercial Contracted Tpa [40055]	$1,291 - $1,506	1209%
Umwa [40037]	$1,506	1410%
Multiplan Generic [40035]	$1,596 - $1,828	1494%
Vhn Generic [40040]	$1,596 - $1,828	1494%
Healthsmart [40013]	$1,613	1510%
Sentara Behavioral Health [40052]	$1,632	1528%
Sentara [40021]	$1,632	1528%
Geha [40009]	$1,660 - $3,579	1554%
First Health Generic [40033]	$1,764	1652%
Gateway Health Alliance [40034]	$1,828	1711%
Onenet Workers Comp Generic [60010]	$1,884	1764%
Kaiser Permenente [40014]	$1,890	1769%

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 $1,050.
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 Uva Health Culpeper Medical Center 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.