CMS Price Transparency Data

CT scan, sinuses

Facility: Jefferson Healthcare

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $560
Cash Discount Price: $1,186
vs. Medicare Baseline: 5.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Jefferson Healthcare is $560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,186. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.24x the Medicare baseline. Located in 834 Sheridan Street, Port Townsend, WA.

Cash / Self-Pay

$1,186

Average discount available for prompt cash payment at this facility.

Insurance Median

$560

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: $1,186 (1110%)

Insurance Median: $560 (524%)

Cash: $1,186 (1110% of Medicare)

Ins. Median: $560 (524% 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 524% of the Medicare baseline (a markup of 424%). 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
Tricare	$40 - $612	37%
Chpw Mcr Adv	$43 - $661	40%
Aetna	$46 - $1,574	43%
Medicare (plans)	$46 - $624	43%
Molina Mcr Adv	$46 - $612	43%
Molina Marketplace-All Other Plans	$50 - $765	47%
Chpw Commercial-All Other Plans	$60 - $1,487	56%
Coord Care Comm/Exchge-All Other Plans	$64 - $1,574	60%
Chpw Mcaid	$80 - $546	75%
Molina Mcaid	$80 - $558	75%
Amerigroup Mcaid-All Plans	$83 - $575	78%
Regence-All Other Plans	$93 - $1,312	87%
Premera-All Plans	$105 - $1,487	98%
Cigna	$112 - $1,574	105%
Coord Care Mcaid Ip/Op Only	$496 - $585	464%
UnitedHealthcare	$830 - $979	777%
Coord Care Cascade Ip/Op Only	$1,334 - $1,574	1249%

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 $1,186.
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 Jefferson Healthcare 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.