CMS Price Transparency Data

CT scan, sinuses

Facility: Charleston Area Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,918
Cash Discount Price: $2,327
vs. Medicare Baseline: 17.96x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Charleston Area Medical Center is $1,918. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,327. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.96x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$2,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,918

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: $2,327 (2179%)

Insurance Median: $1,918 (1796%)

Cash: $2,327 (2179% of Medicare)

Ins. Median: $1,918 (1796% 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 1796% of the Medicare baseline (a markup of 1696%). 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
Aetna	$65 - $2,533	61%
The Health Plan Of West Virginia Inc.	$65 - $2,507	61%
Unicare Health Plan Of West Virginia Inc.	$65	61%
Triwest Va	$104	97%
Blue Cross Blue Shield	$107 - $2,357	100%
Choicecare Network	$107 - $2,533	100%
Optimum Choice Inc.	$107	100%
UnitedHealthcare	$110 - $2,533	103%
West Virginia Senior Advantage Inc.	$112	105%
Integrated Medical Solutions	$208	195%
Naphcare	$214	200%
Caresource	$267	250%
Tricare	$1,174 - $1,551	1099%
City Of Charleston	$1,468 - $1,939	1374%
Cigna	$1,820 - $2,404	1704%
Three Rivers Providers Network	$1,898 - $2,507	1777%
Healthsmart	$1,918 - $2,533	1796%
Multiplan	$1,918 - $2,533	1796%

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 $2,327.
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 Charleston Area Medical Center 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.