CMS Price Transparency Data

CT scan, sinuses

Facility: Shands Jacksonville

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,002
  • Cash Discount Price: $1,827
  • vs. Medicare Baseline: 9.38x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Shands Jacksonville is $1,002. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,827. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.38x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$1,827

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,002

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: $1,827 (1711%)
Insurance Median: $1,002 (938%)
Cash: $1,827 (1711% of Medicare)
Ins. Median: $1,002 (938% 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 938% of the Medicare baseline (a markup of 838%). 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
Carelon Health $74 69%
Humana $74 - $2,823 69%
Aetna $75 - $2,737 70%
Florida Community Care $78 73%
Amerihealth Caritas Florida $81 76%
Community Care Plan $81 76%
Molina $81 - $139 76%
Simply Healthcare $82 77%
Ameri-Plus Preferred Care $109 102%
Blue Cross Blue Shield $109 - $1,684 102%
Capital Health Plan $109 - $1,661 102%
Beacon Health Strategies $112 105%
Careplus Health Plan $112 105%
Florida Health Care Plan $112 - $192 105%
UnitedHealthcare $114 - $1,720 107%
Devoted Health Plan $115 - $120 108%
Positive Healthcare Partners $117 - $120 110%
Wellcare Of Florida $128 120%
Florida Complete Care $136 127%
Wellpath $176 165%
Ambetter / Centene $177 166%
Avmed $857 - $1,614 802%
Volusia Health Network $1,395 1306%
Northeast Florida State Hospital $1,461 1368%
North Florida Evaluation & Treatment Center $1,561 1461%
Cigna $1,719 1609%
Centivo $1,827 1711%
Disney Cruise Line $1,993 1866%
Health First Health Plan $2,159 - $2,325 2021%
Mental Health Associates $2,159 2021%
Prime Health Services $2,325 - $2,491 2177%
Florida Health Alliance $2,392 2239%
Archbold Medical Center $2,491 2332%
Genex $2,491 2332%
Rockport Provider $2,491 2332%
Corvel Corp $2,823 2643%
First Health $2,823 2643%
Florida Hospital Healthcare System $2,823 2643%
Medsave Usa Tpa $2,823 2643%
Fringe Benefits Coordinators $2,989 - $3,155 2798%
Multiplan $2,989 2798%
Novanet $2,989 2798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals