CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $8,112
  • Cash Discount Price: $26,169
  • vs. Medicare Baseline: 45.27x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Central Florida Lake Monroe Hospital is $8,112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,169. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 45.27x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$26,169

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,112

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Cash / Self-Pay: $26,169 (14603%)
Insurance Median: $8,112 (4527%)
Cash: $26,169 (14603% of Medicare)
Ins. Median: $8,112 (4527% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 4527% of the Medicare baseline (a markup of 4427%). 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 $402 - $11,776 224%
Aetna $1,186 - $7,851 662%
Avmed $1,695 - $13,084 946%
Freedom Health $1,884 1051%
Optimum $1,884 1051%
Corvel Corporation $2,790 1557%
Prime Health $2,849 1590%
Careworks (Rockport Community) $2,937 1639%
Simply $4,030 2249%
Molina Healthcare $4,972 - $8,374 2775%
Sunshine State Health Plan $6,673 3724%
Plotkin Health $13,084 7301%
Prime Health Sheriff $13,084 7301%
Multiplan $19,627 - $22,244 10953%
Three Rivers Provider Network $19,627 10953%
Ppo Next $22,244 12413%
Novanet $23,552 13143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals