CMS Price Transparency Data

CT scan, sinuses

Facility: Lower Keys Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $205
  • Cash Discount Price: $1,531
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Lower Keys Medical Center is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,531. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.92x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$1,531

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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: $1,531 (1433%)
Insurance Median: $205 (192%)
Cash: $1,531 (1433% of Medicare)
Ins. Median: $205 (192% 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
UnitedHealthcare $62 - $3,797 58%
Veterans Eval Services $100 94%
Florida Childrens Medical Services $103 96%
Medicaid / KanCare $103 - $113 96%
South Florida Community Care Network $103 96%
Humana $106 - $115 99%
Tricare $111 104%
Amerigroup $113 106%
Positive Healthcare $113 106%
Simply Healthcare $113 - $1,531 106%
Wellcare $113 106%
Wellcare Healthease $113 106%
Blue Cross Blue Shield $115 - $4,938 108%
Medicare (plans) $115 108%
Ultimate Health $115 108%
Molina $116 109%
Node Champva $117 110%
Node Non Par Hospice Agree $117 110%
Node United Behavioral Va Ccn $117 110%
Node Va $117 110%
Prestige Health Choice $119 111%
Magellan $123 115%
Correct Care Solutions $129 121%
Node Us Dept Of Labor $146 137%
Prime Health Work Comp Fl $171 160%
Fl Work Comp $176 165%
Heritage Summit Work Comp Fl $176 165%
State Auto Insurance Fl $234 219%
Self Pay $1,333 - $1,728 1248%
Cigna $2,914 2728%
Aetna $3,447 3227%
Monroe County $3,704 3468%
Evolutions Healthcare Systems $3,951 - $4,691 3699%
Keys Energy $3,951 3699%
Prime Health Ppo $3,951 3699%
Avmed Health Plan $4,197 3929%
Direct Healthcare $4,938 4623%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals