CMS Price Transparency Data

CT scan, sinuses

Facility: Vandalia Health Broaddus Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,431
  • Cash Discount Price: $1,367
  • vs. Medicare Baseline: 13.40x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Vandalia Health Broaddus Hospital is $1,431. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,367. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.40x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.
Cash / Self-Pay
$1,367

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,431

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: $1,367 (1280%)
Insurance Median: $1,431 (1340%)
Cash: $1,367 (1280% of Medicare)
Ins. Median: $1,431 (1340% 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 1340% of the Medicare baseline (a markup of 1240%). 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
Correctional Medical Systems $29 - $87 27%
Aetna $30 - $1,746 28%
The Health Plan $30 - $1,758 28%
Unicare $30 - $91 28%
Blue Cross Blue Shield $74 - $1,385 69%
Peak Health $337 - $622 316%
Highmark $1,431 1340%
UnitedHealthcare $1,445 - $1,896 1353%
Humana $1,503 1407%
West Virginia Senior Advantage $1,517 1420%
Cigna $1,709 1600%
First Health $1,746 1635%
Geisenger Health Plan $1,816 1700%
Health Network America $1,816 - $1,855 1700%
Multiplan/Phcs $1,836 1719%
Geha $1,855 1737%
Selectnet $1,914 1792%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Healthcare Drive Mansfield Hill, Philippi, WV 26416
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals