CMS Price Transparency Data

CT scan, sinuses

Facility: St Marys Hospital Superior

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,273
  • Cash Discount Price: $1,392
  • vs. Medicare Baseline: 11.92x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at St Marys Hospital Superior is $1,273. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,392. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.92x the Medicare baseline. Located in 3500 Tower Ave, Superior, WI.
Cash / Self-Pay
$1,392

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,273

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: $1,392 (1303%)
Insurance Median: $1,273 (1192%)
Cash: $1,392 (1303% of Medicare)
Ins. Median: $1,273 (1192% 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 1192% of the Medicare baseline (a markup of 1092%). 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
Itasca Med Care $106 99%
Primewest $106 99%
Advocare/Security Health $603 565%
Blue Cross Blue Shield $603 - $1,512 565%
Freedom Blue Ppo $603 565%
Healthpartners Care Msho / Mcr Adv $603 565%
Imcare Msho Pcc Prime $603 565%
Imcare Msho Ref Req $603 565%
Medica Advantage Solutions $603 565%
Medica Msho/Dual Solutions $603 565%
Medica Prime Solution Group $603 565%
Medica Uplan $603 565%
Medicare (plans) $603 565%
Nd Va Administration $603 565%
Platinum Blue/Vantage Blue $603 565%
Primewest Msho $603 565%
Secure Blue Msho $603 565%
Ubh Cost Plan $603 565%
Ubh Msho $603 565%
Ucare Msho $603 565%
UnitedHealthcare $603 - $1,704 565%
Blue Plus Pmap Pcc Prime $723 - $1,036 677%
Healthpartners Care Pmap $757 709%
Medica Access $757 - $1,183 709%
Sanford Healthplan $808 - $850 756%
Ucare $1,239 1160%
Healthpartners $1,273 - $1,501 1192%
Medica $1,324 - $1,471 1240%
Wea $1,356 - $1,450 1270%
Security Health $1,450 1358%
America'S Ppo $1,459 1366%
Cigna $1,469 - $1,501 1375%
Healthpartners Pcc Prime $1,469 - $1,501 1375%
Medica Choice $1,514 1417%
Wps $1,563 - $1,582 1463%
Aetna $1,601 1499%
Healtheos $1,619 1516%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 Tower Ave, Superior, WI 54880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals