CMS Price Transparency Data

CT scan, sinuses

Facility: North Shore Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $146
  • Cash Discount Price: $8,200
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at North Shore Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,200. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.37x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$8,200

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

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: $8,200 (7677%)
Insurance Median: $146 (137%)
Cash: $8,200 (7677% of Medicare)
Ins. Median: $146 (137% 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.

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
Humana $59 - $206 55%
Medicaid / KanCare $68 - $8,200 64%
UnitedHealthcare $69 - $103 65%
Veterans Administration Mill Bill $72 67%
Medicare (plans) $93 - $8,200 87%
Aetna $103 - $5,904 96%
Devoted Health $103 96%
Leon Health Inc $103 96%
Tricare $104 97%
Employer Direct Healthcare $105 - $164 98%
Hospice Other $105 98%
Veterans Administration Vaccn $105 98%
Cigna $108 - $4,100 101%
Healthsun Health Plans $108 - $136 101%
Longevity Health Plan $110 103%
Avmed Broad Network $116 109%
Florida Pace Centers $124 116%
Bright Health Management Commercial $126 118%
Centurion Prison $129 121%
Self Pay/Uninsured $129 - $161 121%
Dimension Health Wc $146 137%
Workers Compensation $146 137%
Imagine Health $153 143%
Avmed Exchange $183 171%
Oscar Health Plan Hix $188 176%
Ambetter / Centene $194 182%
Molina Marketplace Program Exchange $199 186%
Auto Insurance $209 196%
Avmed Select Network $214 200%
Amerihealth Caritas Next Exchange $225 211%
Bc/Bs Of Fl Health Options Hmo $327 306%
Bc/Bs Of Fl Network Blue $330 309%
Bc/Bs Myblue Hmo Hix $337 316%
Bc/Bs Of Fl Simplyblue $354 331%
Bc/Bs Of Fl Blue Select Exchange Non Par $364 341%
Bc/Bs Of Fl Ppo $387 362%
Bc/Bs Of Fl Phs $4,251 3980%
Magellan Behavioral Health $4,920 4606%
Dimensions International $5,330 4990%
First Health $5,576 5220%
Dimension Health Ppo $6,150 5758%
Beacon Health Strategies Commercial $8,200 7677%
Commercial Non-Contracted $8,200 7677%
Self Pay - Mcd Pending 100 Percent $8,200 7677%
Single Case Agreement $8,200 7677%
United Behavioral Health Psych $8,200 7677%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals