CMS Price Transparency Data

CT scan, sinuses

Facility: Lewisgale Hospital Montgomery

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $632
Cash Discount Price: $2,289
vs. Medicare Baseline: 5.92x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Lewisgale Hospital Montgomery is $632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,289. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.92x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$2,289

Average discount available for prompt cash payment at this facility.

Insurance Median

$632

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: $2,289 (2143%)

Insurance Median: $632 (592%)

Cash: $2,289 (2143% of Medicare)

Ins. Median: $632 (592% 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 592% of the Medicare baseline (a markup of 492%). 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
Cigna	$127 - $669	119%
Lifeworks	$139 - $731	130%
Universal Healthcare Group	$161 - $846	151%
Blue Cross Blue Shield	$168 - $621	157%
United	$245 - $1,731	229%
Virginia Health Network	$256 - $2,731	240%
Greenvbrier Sporting Club	$439 - $2,308	411%
Corvel	$526 - $2,769	492%
Richfield Nursing Center	$548 - $2,884	513%
Richfield Retirement Community	$548 - $2,884	513%
Multiplan	$563 - $2,961	527%
Community Care Network	$585 - $3,077	548%
Graham-White Manufacturing	$585 - $3,077	548%
Occunet Workers Comp	$585 - $3,077	548%
One Health Plan	$585 - $3,077	548%
Phcs	$621 - $3,269	581%
Patients Choice	$643 - $3,384	602%
4Most	$658 - $3,461	616%
American Postal Workers Union	$658 - $3,461	616%
Star Transportation	$658 - $3,461	616%
Aetna	$2,807 - $4,356	2628%

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 $2,289.
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 Lewisgale Hospital Montgomery 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.