CMS Price Transparency Data

CT scan, sinuses

Facility: Spotsylvania Regional Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,475
  • Cash Discount Price: $4,782
  • vs. Medicare Baseline: 13.81x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Spotsylvania Regional Medical Center is $1,475. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,782. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.81x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
$4,782

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,475

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: $4,782 (4477%)
Insurance Median: $1,475 (1381%)
Cash: $4,782 (4477% of Medicare)
Ins. Median: $1,475 (1381% 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 1381% of the Medicare baseline (a markup of 1281%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $102 - $468 95%
United $245 - $2,152 229%
Lifeworks $909 851%
Cigna $1,272 - $1,612 1191%
Virginia Health Network $1,674 - $3,108 1567%
Aetna $1,819 1703%
Kaiser $2,821 2641%
Greenvbrier Sporting Club $2,869 2686%
Multiplan $3,395 3179%
Corvel $3,443 3223%
Occunet Workers Comp $3,826 3582%
4Most Health Nework $4,304 4030%
Three Rivers Provider Network $4,304 4030%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals