CMS Price Transparency Data

CT scan, sinuses

Facility: Bellin Health Oconto Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $424
Cash Discount Price: $359
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Bellin Health Oconto Hospital is $424. 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 3.97x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$424

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: $424 (397%)

Cash: $359 (336% of Medicare)

Ins. Median: $424 (397% 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 397% of the Medicare baseline (a markup of 297%). 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
Blue Cross Blue Shield	$188 - $1,424	176%
Community Care	$188	176%
Humana	$188	176%
My Choice	$188	176%
Network Health	$188 - $470	176%
UnitedHealthcare	$227 - $387	213%
Aetna	$276	258%
Cigna	$391 - $398	366%
Common Ground	$402 - $414	376%
Chorus Community Health Plan	$415	389%
Aspirus Arise	$433	405%
Healthsmart	$442	414%
Ihs(Claimsbridge)	$442	414%
Medical College Of Wi	$442	414%
Hps/Paymedix	$453 - $492	424%
Wps Insurance	$464	434%
Allied National	$470	440%
First Health	$470	440%
Galaxy Health	$470	440%
Three Rivers Provider Network	$498	466%
Trilogy	$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 Health Oconto 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.