CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Lake City Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $5,054
Cash Discount Price: $10,667
vs. Medicare Baseline: 47.32x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Lake City Hospital is $5,054. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,667. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 47.32x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

$10,667

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,054

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: $10,667 (9987%)

Insurance Median: $5,054 (4732%)

Cash: $10,667 (9987% of Medicare)

Ins. Median: $5,054 (4732% 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 4732% of the Medicare baseline (a markup of 4632%). 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 - $5,028	229%
Aetna	$968 - $3,352	906%
Avmed	$981 - $5,586	918%
Simply	$1,565 - $1,721	1465%
Corvel Corporation	$1,868	1749%
Prime Health	$1,907	1785%
Careworks (Rockport Community)	$1,966	1841%
Sunshine State Health Plan	$2,591 - $2,849	2426%
Molina Healthcare	$3,252 - $3,575	3045%
Plotkin Health	$5,081 - $5,586	4757%
Prime Health Sheriff	$5,081 - $5,586	4757%
Hamilton County Jail	$5,487 - $6,033	5137%
Multiplan	$7,926 - $9,497	7421%
Evolutions	$8,637 - $9,497	8086%
Ppo Next	$8,637 - $9,497	8086%
Novanet	$9,145 - $10,055	8562%

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 $10,667.
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 Lake City 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.