CT scan, sinuses
Facility: Physicians Care Surgical Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $385
- Cash Discount Price: $285
- vs. Medicare Baseline: 3.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 360% of the Medicare baseline (a markup of 260%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Connecticare | $124 | 116% |
| Blue Cross Blue Shield | $194 - $385 | 182% |
| Highmark | $194 | 182% |
| Keystone 65 HMO | $357 | 334% |
| Cigna | $357 | 334% |
| Personal Choice 65 | $357 | 334% |
| Shenandoah Life | $357 | 334% |
| Humana | $357 | 334% |
| Devon Health Services | $357 | 334% |
| Tricare | $357 | 334% |
| Ibc Security 65 | $357 | 334% |
| Gpm Health and Life Insurance Mc Supplement | $357 | 334% |
| UnitedHealthcare | $357 - $756 | 334% |
| Medicare (plans) | $357 | 334% |
| Vibra Health Plan | $357 | 334% |
| Aarp | $357 | 334% |
| Pcsh Aarp | $357 | 334% |
| Aetna | $357 - $730 | 334% |
| Unified Health Services | $357 | 334% |
| Personal Choice | $385 | 360% |
| Amerihealth New Jersey HMO | $385 | 360% |
| Ibc 2021 | $385 | 360% |
| Carefirst Administrators | $385 | 360% |
| Independence Administrators | $385 | 360% |
| Keystone Direct POS | $385 | 360% |
| Independence Bc | $385 | 360% |
| Ibc | $385 | 360% |
| Regence Blue Shield | $385 | 360% |
| Independence Federal | $385 | 360% |
| Ibc Local | $385 | 360% |
| Amerihealth Administrators | $385 | 360% |
| Ibc - Local | $385 | 360% |
| Keystone Healthplan East | $385 | 360% |
| Horizon of New Jersey | $385 | 360% |
| Empire Plan | $385 | 360% |
| Pcsh Ibc | $385 | 360% |
| Keystone HMO | $385 | 360% |
| Geha | $730 | 683% |
| Marpai Health | $730 | 683% |
| Ag Administrators | $730 | 683% |
| Meritain Health | $730 | 683% |
| Lucent Health | $730 | 683% |
| Premier Care Network | $730 | 683% |
| Continental Benefits | $730 | 683% |
| Trustmark | $730 | 683% |
| Allied Benefits Systems | $730 | 683% |
| Allied Benefit Systems | $730 | 683% |
| Healthez | $730 | 683% |
| Ag Administrators Inc | $730 | 683% |
| Coventry | $730 | 683% |
| Golden Rule Op | $756 | 708% |
| Oxford Life Insurance Company | $756 | 708% |
| Oxford Health Plan | $756 | 708% |
| Surest | $756 | 708% |
| Allsavers | $756 | 708% |