CMS Price Transparency Data

CT scan, sinuses

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $146
Cash Discount Price: $3,819
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Univ. of Vermont - Fletcher Allen Health Care is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,819. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.37x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$3,819

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $3,819 (3576%)

Insurance Median: $146 (137%)

Cash: $3,819 (3576% of Medicare)

Ins. Median: $146 (137% 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.

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
UnitedHealthcare	$27 - $3,759	25%
Mvp	$33 - $2,689	31%
Blue Cross Blue Shield	$37 - $3,636	35%
Aetna	$38 - $125	36%
Capital District Physicians' Health Plan	$38 - $2,860	36%
Humana	$38 - $1,069	36%
Martins Point	$38 - $125	36%
St. Regis	$38 - $125	36%
Veterans Affairs Community Care Network	$38 - $125	36%
Fidelis Care	$44 - $143	41%
Wellpath	$54 - $2,100	51%
Ebpa	$141 - $3,284	132%
Harvard Pilgrim	$146 - $3,055	137%
Magnacare	$146 - $3,055	137%
Coventry	$156 - $3,246	146%
Nppn	$165 - $3,437	154%
Cigna	$171 - $3,437	160%

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 $3,819.
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 Univ. of Vermont - Fletcher Allen Health Care 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.