CMS Price Transparency Data

CT scan, sinuses

Facility: Grant Regional Health Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,200
  • Cash Discount Price: $1,605
  • vs. Medicare Baseline: 11.23x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Grant Regional Health Center is $1,200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,605. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.23x the Medicare baseline. Located in 507 S Monroe St, Lancaster, WI.
Cash / Self-Pay
$1,605

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,200

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: $1,605 (1503%)
Insurance Median: $1,200 (1123%)
Cash: $1,605 (1503% of Medicare)
Ins. Median: $1,200 (1123% 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 1123% of the Medicare baseline (a markup of 1023%). 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
Americhoice Mcaid - All Plans $191 179%
Medical Associates - All Plans $735 688%
Quartz Mcr Adv $1,086 1017%
UnitedHealthcare $1,086 - $2,197 1017%
Quartz Health Solution - All Other Plans $1,200 1123%
The Alliance - All Plans $1,869 1750%
Wps - All Plans $2,005 1877%
Blue Cross Blue Shield $2,099 1965%
Dean Health Plan - All Plans $8,366 7833%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 S Monroe St, Lancaster, WI 53813
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals