CMS Price Transparency Data

CT scan, sinuses

Facility: Astria Sunnyside Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,252
Cash Discount Price: $1,458
vs. Medicare Baseline: 11.72x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Astria Sunnyside Hospital is $1,252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,458. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.72x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$1,458

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,252

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: $1,458 (1365%)

Insurance Median: $1,252 (1172%)

Cash: $1,458 (1365% of Medicare)

Ins. Median: $1,252 (1172% 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 1172% of the Medicare baseline (a markup of 1072%). 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
Medicare (plans)	$155 - $677	145%
Medicaid / KanCare	$465 - $822	435%
Aetna	$597 - $2,359	559%
Healthcomp_Ihs	$597 - $658	559%
Humana	$597 - $2,413	559%
Molina	$597 - $658	559%
Va	$597 - $658	559%
Tricare	$603 - $664	565%
Regence	$1,252 - $1,378	1172%
Cigna	$1,462 - $1,609	1369%
Li	$1,496 - $1,646	1401%
First_Choice	$1,827 - $2,011	1711%
Tpsc	$1,900 - $2,091	1779%
Kaiser	$1,913 - $2,105	1791%
Premera	$1,983 - $2,182	1857%
UnitedHealthcare	$2,071 - $2,279	1939%
Fhpw	$2,144 - $2,359	2007%
Healthcomp	$2,192 - $2,413	2052%
Bcchp	$2,436 - $2,681	2281%
Great_Rivers	$2,436 - $2,681	2281%
Zenith	$2,436 - $2,681	2281%

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 $1,458.
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 Astria Sunnyside 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.