CMS Price Transparency Data

CT scan, sinuses

Facility: Sauk Prairie Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $139
Cash Discount Price: $1,823
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Sauk Prairie Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,823. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.30x the Medicare baseline. Located in 260 26Th Street, Prairie Du Sac, WI.

Cash / Self-Pay

$1,823

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $1,823 (1707%)

Insurance Median: $139 (130%)

Cash: $1,823 (1707% of Medicare)

Ins. Median: $139 (130% 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.

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
Blue Cross Blue Shield	$32 - $4,775	30%
Dean Health Plan	$38 - $1,125	36%
Humana	$38 - $103	36%
Quartz	$38 - $280	36%
UnitedHealthcare	$38 - $3,167	36%
The Alliance	$175 - $2,667	164%
Ghc	$2,333	2184%

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 $1,823.
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 Sauk Prairie 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.