CMS Price Transparency Data

CT scan, sinuses

Facility: Lewisgale Hospital Alleghany

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,968
Cash Discount Price: $5,793
vs. Medicare Baseline: 27.79x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Lewisgale Hospital Alleghany is $2,968. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,793. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 27.79x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.

Cash / Self-Pay

$5,793

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,968

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: $5,793 (5424%)

Insurance Median: $2,968 (2779%)

Cash: $5,793 (5424% of Medicare)

Ins. Median: $2,968 (2779% 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 2779% of the Medicare baseline (a markup of 2679%). 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	$205 - $759	192%
United	$245 - $2,607	229%
Lifeworks	$1,101	1031%
Universal Healthcare Group	$1,274	1193%
Virginia Health Network	$2,028 - $4,113	1899%
Aetna	$2,807 - $3,128	2628%
Greenvbrier Sporting Club	$3,476	3254%
Corvel	$4,171	3905%
Occunet Workers Comp	$4,634	4339%
Csx Hotels	$4,634	4339%
Health Payors Organization	$4,924	4610%
Alleghany Highland Community	$5,214	4882%
American Postal Workers Union	$5,214	4882%
One Health Plan	$5,214	4882%
4Most	$5,214	4882%
Community Care Network	$5,214	4882%
C&O Employees Hospital Assn	$5,214	4882%
Multiplan	$5,214	4882%

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 $5,793.
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 Alleghany 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.