CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $6,265
  • Cash Discount Price: $20,209
  • vs. Medicare Baseline: 34.96x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Central Florida Lake Monroe Hospital is $6,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,209. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 34.96x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$20,209

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,265

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: $20,209 (11277%)
Insurance Median: $6,265 (3496%)
Cash: $20,209 (11277% of Medicare)
Ins. Median: $6,265 (3496% 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 3496% of the Medicare baseline (a markup of 3396%). 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 - $9,094 224%
Aetna $1,186 - $6,063 662%
Freedom Health $1,455 812%
Optimum $1,455 812%
Avmed $1,695 - $10,104 946%
Simply $3,112 1737%
Corvel Corporation $3,298 1840%
Prime Health $3,367 1879%
Careworks (Rockport Community) $3,471 1937%
Molina Healthcare $3,840 - $6,467 2143%
Sunshine State Health Plan $5,153 2876%
Plotkin Health $10,104 5638%
Prime Health Sheriff $10,104 5638%
Multiplan $15,157 - $17,177 8458%
Three Rivers Provider Network $15,157 8458%
Ppo Next $17,177 9585%
Novanet $18,188 10150%

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