CMS Price Transparency Data

CT scan, sinuses

Facility: Childrens Hospital of Wisconsin

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $948
  • Cash Discount Price: $626
  • vs. Medicare Baseline: 8.88x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Childrens Hospital of Wisconsin is $948. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $626. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.88x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$626

Average discount available for prompt cash payment at this facility.

Insurance Median
$948

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: $626 (586%)
Insurance Median: $948 (888%)
Cash: $626 (586% of Medicare)
Ins. Median: $948 (888% 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 888% of the Medicare baseline (a markup of 788%). 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
Froedtert Health $727 - $2,125 681%
Medical College Of Wisconsin $727 - $1,750 681%
Network Health Plan $739 - $1,780 692%
UnitedHealthcare $763 - $1,902 714%
Aspirus Health Plan $778 - $1,875 728%
Common Ground Healthcare Cooperative $778 - $2,125 728%
Trilogy Health Solutions $778 - $2,125 728%
Wps Health Plan $789 - $2,250 739%
Advocate Aurora Healthcare $799 - $1,925 748%
Blue Cross Blue Shield $810 - $2,375 758%
Centivo $810 - $1,950 758%
Health Partners $810 - $2,200 758%
Employer Health Care Alliance Cooperative $815 - $1,962 763%
Dean Health Plan $830 - $2,000 777%
Group Health Cooperative Of Eau Claire $830 - $2,000 777%
Oan Llc $830 - $2,000 777%
Security Health Plan $862 - $2,075 807%
Health Payment Systems $878 - $2,115 822%
Praire States $882 - $2,125 826%
Quartz Health Insurance $882 - $2,125 826%
Sheboygan Employer'S Health Network $882 - $2,125 826%
Mayo Clinic Health Solutions $903 - $2,175 845%
Aetna $913 - $2,225 855%
Bellin Thedacare $934 - $2,250 874%
Cigna $934 - $2,250 874%
Group Health Cooperative Of South Central Wisconsin $934 - $2,250 874%
Prevea Health Network $934 - $2,250 874%
Multiplan $945 - $2,375 885%
Coventry Health Care $986 - $2,375 923%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens