CMS Price Transparency Data

CT scan, sinuses

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,802
  • Cash Discount Price: $1,718
  • vs. Medicare Baseline: 16.87x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at University of Wi Hospitals & Clinics Authority is $1,802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,718. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.87x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$1,718

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,802

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: $1,718 (1608%)
Insurance Median: $1,802 (1687%)
Cash: $1,718 (1608% of Medicare)
Ins. Median: $1,802 (1687% 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 1687% of the Medicare baseline (a markup of 1587%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $107 - $2,570 100%
Blue Cross Blue Shield $107 - $3,045 100%
Humana $107 100%
Medicare (plans) $107 - $109 100%
UnitedHealthcare $107 - $2,006 100%
Alliance_Premier_Network $1,204 - $1,531 1127%
Mercycare $1,250 - $1,590 1170%
Triology $1,286 - $1,955 1204%
Security_Health_Plan $1,361 - $2,035 1274%
Employer'S_Coalition_On_Health $1,387 - $2,468 1299%
Alliance $1,418 - $1,802 1328%
Hfn $1,437 - $2,468 1345%
United_Healthcare $1,445 - $2,721 1353%
Beloit_Health_System $1,462 - $1,859 1369%
Aspirus_Health_Plan $1,472 - $1,872 1378%
Cigna $1,513 - $1,923 1417%
Health_Partners_Insurance $1,538 - $1,955 1440%
Health_Payment_Systems $1,545 - $1,964 1446%
Dean_Health_Plan $1,613 - $2,051 1510%
Medical_Associates $1,664 - $2,115 1558%
Wps $1,747 - $2,445 1636%
Employers_Healthcare_Coalition_Of_Wi $1,765 - $2,244 1652%
Aspirus_Network_Inc $1,941 - $2,468 1817%
Chorus_Community $2,017 - $2,564 1888%
Ghc_Eau_Claire_Health_Plan $2,017 - $2,564 1888%
Multiplan $2,017 - $2,949 1888%
Sheybogan_Employers_Health_Network $2,017 - $2,564 1888%
Coventry $2,143 - $2,724 2006%
Dean_Care $2,143 - $2,724 2006%
Healthsmart $2,218 - $2,820 2077%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals