CMS Price Transparency Data

CT scan, sinuses

Facility: Reston Hospital Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,182
Cash Discount Price: $4,223
vs. Medicare Baseline: 11.07x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Reston Hospital Center is $1,182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,223. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.07x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$4,223

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,182

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: $4,223 (3954%)

Insurance Median: $1,182 (1107%)

Cash: $4,223 (3954% of Medicare)

Ins. Median: $1,182 (1107% 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 1107% of the Medicare baseline (a markup of 1007%). 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
Blue Cross Blue Shield	$151 - $546	141%
United	$245 - $1,918	229%
Lifeworks	$795 - $810	744%
Cigna	$828 - $1,436	775%
Universal Healthcare Group	$921 - $938	862%
Carefirst	$1,109	1038%
Aetna	$1,819	1703%
Greenvbrier Sporting Club	$2,511 - $2,557	2351%
Virginia Health Network	$2,971 - $3,026	2782%
Corvel	$3,013 - $3,068	2821%
Occunet Workers Comp	$3,347 - $3,409	3134%
4Most Health Network	$3,766 - $3,836	3526%

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 $4,223.
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 Reston Hospital 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.