CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Lehigh Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,684
Cash Discount Price: $17,430
vs. Medicare Baseline: 25.13x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Lehigh Hospital is $2,684. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,430. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 25.13x the Medicare baseline. Located in 1500 Lee Blvd, Lehigh Acres, FL.

Cash / Self-Pay

$17,430

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,684

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: $17,430 (16319%)

Insurance Median: $2,684 (2513%)

Cash: $17,430 (16319% of Medicare)

Ins. Median: $2,684 (2513% 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 2513% of the Medicare baseline (a markup of 2413%). 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 - $2,858	229%
Aetna	$848 - $5,229	794%
Freedom Health Care	$1,360	1273%
Optimum Healthcare	$1,360	1273%
Simply Healthcare	$2,684	2513%
Sunshine State Health Plan	$4,445	4162%
Evolutions Healthcare Systems	$8,715 - $16,035	8159%
Plotkin Health	$8,715	8159%

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 $17,430.
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 Lehigh 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.