CMS Price Transparency Data

CT scan, sinuses

Facility: Othello Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,490
Cash Discount Price: $1,397
vs. Medicare Baseline: 13.95x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Othello Community Hospital is $1,490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,397. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.95x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.

Cash / Self-Pay

$1,397

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,490

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: $1,397 (1308%)

Insurance Median: $1,490 (1395%)

Cash: $1,397 (1308% of Medicare)

Ins. Median: $1,490 (1395% 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 1395% of the Medicare baseline (a markup of 1295%). 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
Ambetter / Centene	$792 - $801	742%
Amerigroup Mcaid	$792	742%
Chp Mcaid	$792	742%
Cocare - All Plans	$792	742%
Gau - All Plans	$792	742%
Kaiser - All Plans	$792	742%
Molina Mcaid	$792	742%
UnitedHealthcare	$792 - $1,863	742%
Chp - All Other Plans	$801	750%
Molina - All Other Plans	$801	750%
Medicare (plans)	$932	873%
Tricare	$1,211	1134%
Triwest - All Plans	$1,211	1134%
Asuris - All Plans	$1,490	1395%
Commercial Other - All Plans	$1,490	1395%
Hma - All Plans	$1,490	1395%
Hmso - All Plans	$1,490	1395%
Tpsc - All Plans	$1,490	1395%
Travelers - All Plans	$1,490	1395%
Veterans Admin - All Plans	$1,490	1395%
Blue Cross Blue Shield	$1,565	1465%
Cigna	$1,658	1552%
First Choice - All Plans	$1,677	1570%
Aetna	$1,751	1639%
Chp Mcr Adv	$1,863	1744%
Health Alliance Mcr Adv - All Plans	$1,863	1744%
Humana	$1,863	1744%
Molina Mcare	$1,863	1744%
Wellcare Mcr Adv - All Plans	$1,863	1744%

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 $1,397.
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 Othello Community Hospital 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.