CMS Price Transparency Data

CT scan, sinuses

Facility: Forks Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $788
Cash Discount Price: $1,500
vs. Medicare Baseline: 7.38x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Forks Community Hospital is $788. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,500. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.38x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$1,500

Average discount available for prompt cash payment at this facility.

Insurance Median

$788

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: $1,500 (1404%)

Insurance Median: $788 (738%)

Cash: $1,500 (1404% of Medicare)

Ins. Median: $788 (738% 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 738% of the Medicare baseline (a markup of 638%). 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
Medicaid / KanCare	$272 - $1,085	255%
Coordinated Care (Mco) Mcd-All Plans	$294 - $1,106	275%
Medicare (plans)	$318	298%
UnitedHealthcare	$351 - $2,517	329%
Community Health Network Mcr-All Other Plans	$355 - $1,332	332%
Humana	$355 - $1,332	332%
Tricare	$355 - $1,332	332%
Triwest-All Plans	$355 - $1,332	332%
Ambetter / Centene	$411 - $1,546	385%
Wellcare Med Adv - All Plans	$411 - $1,546	385%
Regence-All Other Plans	$454 - $1,705	425%
Community Health Exchange	$512 - $1,925	479%
Molina Commercial-All Other Plans	$725 - $2,724	679%
Aetna	$749 - $2,813	701%
Blue Cross Blue Shield	$749 - $2,813	701%
Cigna	$788 - $2,961	738%
First Choice-All Plans	$788 - $2,961	738%

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 $1,500.
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 Forks 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.