CMS Price Transparency Data

CT scan, sinuses

Facility: Bellin Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $389
Cash Discount Price: $359
vs. Medicare Baseline: 3.64x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Bellin Memorial Hospital is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.64x the Medicare baseline. Located in 744 S Webster Ave, Green Bay, WI.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$389

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: $359 (336%)

Insurance Median: $389 (364%)

Cash: $359 (336% of Medicare)

Ins. Median: $389 (364% 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 364% of the Medicare baseline (a markup of 264%). 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
Aetna	$100 - $143	94%
Community Care	$100 - $311	94%
Humana	$100 - $311	94%
My Choice	$100 - $143	94%
Network Health	$101 - $1,628	95%
UnitedHealthcare	$105 - $806	98%
Blue Cross Blue Shield	$143 - $480	134%
Common Ground	$332	311%
Chorus Community Health Plan	$356	333%
Aspirus Arise	$382 - $399	358%
Cigna	$390 - $394	365%
Wps Insurance	$403 - $470	377%
Hps/Paymedix	$409 - $442	383%
Trilogy	$420	393%
Healthsmart	$442	414%
Ihs(Claimsbridge)	$442	414%
Medical College Of Wi	$442	414%
Multiplan	$442	414%
Allied National	$470	440%
First Health	$470	440%
Galaxy Health	$470	440%
Three Rivers Provider Network	$498	466%

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 $359.
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 Bellin Memorial 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.