CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Highlands Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,622
  • Cash Discount Price: $6,637
  • vs. Medicare Baseline: 24.55x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Highlands Hospital is $2,622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,637. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 24.55x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$6,637

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,622

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: $6,637 (6214%)
Insurance Median: $2,622 (2455%)
Cash: $6,637 (6214% of Medicare)
Ins. Median: $2,622 (2455% 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 2455% of the Medicare baseline (a markup of 2355%). 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
United $245 - $2,987 229%
Freedom Health $571 535%
Avmed $890 - $3,879 833%
Aetna $1,087 - $1,991 1018%
Molina $1,261 1181%
Prime Health $1,859 1740%
Office Of Sheiff Highland Co $2,323 2175%
United Ppo $2,920 2734%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals