CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Citrus Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,914
Cash Discount Price: $15,126
vs. Medicare Baseline: 17.92x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Citrus Hospital is $1,914. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,126. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.92x the Medicare baseline. Located in 502 W Highland Blvd, Inverness, FL.

Cash / Self-Pay

$15,126

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,914

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: $15,126 (14162%)

Insurance Median: $1,914 (1792%)

Cash: $15,126 (14162% of Medicare)

Ins. Median: $1,914 (1792% 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 1792% of the Medicare baseline (a markup of 1692%). 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
United	$245 - $6,807	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$711	666%
Avmed	$738 - $1,863	691%
Aetna	$757 - $4,538	709%
Access 2 Healthcare Physicians Freedom Health	$908	850%
Access 2 Healthcare Physicians Optimum	$908	850%
Freedom Health Care	$983	920%
Optimum Healthcare	$983	920%
Corvel Corporation	$1,875	1755%
Rockport Healthcare Group	$1,875	1755%
Prime Health	$1,914	1792%
Molina	$2,874 - $4,084	2691%
Sunshine State Health Plan	$3,857	3611%
Beacon Health Options	$7,563	7081%
Plotkin Health	$7,563	7081%
Prime Health Sheriff	$7,563	7081%
Evolutions Healthcare Systems	$9,076 - $13,916	8497%
Multiplan	$11,345 - $12,857	10622%
Evernorth	$12,101	11329%

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 $15,126.
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 HCA Florida Citrus Hospital 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.