CMS Price Transparency Data

CT scan, sinuses

Facility: Morton Plant North Bay Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,739
Cash Discount Price: $2,632
vs. Medicare Baseline: 16.28x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Morton Plant North Bay Hospital is $1,739. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,632. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.28x the Medicare baseline. Located in 6600 Madison Street, New Port Richey, FL.

Cash / Self-Pay

$2,632

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,739

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: $2,632 (2464%)

Insurance Median: $1,739 (1628%)

Cash: $2,632 (2464% of Medicare)

Ins. Median: $1,739 (1628% 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 1628% of the Medicare baseline (a markup of 1528%). 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
Clear Health Alliance	$68	64%
UnitedHealthcare	$69 - $3,947	65%
Humana	$70 - $133	66%
Freedom Health	$71	66%
Molina Healthcare	$71	66%
Simply Healthcare	$71 - $789	66%
Sunshine Health	$71	66%
Aetna	$72 - $3,575	67%
Florida Community Care	$74	69%
Baycareplus	$107	100%
Blue Cross Blue Shield	$107 - $2,321	100%
Solis Health	$117	110%
Cigna	$123 - $3,816	115%
Wellcare	$149	140%
Ambetter / Centene	$240 - $4,386	225%
Molina	$789 - $2,592	739%
Freedom	$877	821%
Optimum	$877	821%
Careplus	$1,002	938%
Ultimate Health Plan	$1,316	1232%
Avmed	$1,360 - $2,149	1273%
Evolutions	$2,193 - $4,079	2053%
First Health	$3,728	3490%
Multiplan	$3,947	3695%
United Behavioral Health	$4,386	4106%

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 $2,632.
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 Morton Plant North Bay 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.