CMS Price Transparency Data

CT scan, sinuses

Facility: Coral Gables Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $126
  • Cash Discount Price: $8,200
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Coral Gables Hospital is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,200. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.18x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$8,200

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $8,200 (7677%)
Insurance Median: $126 (118%)
Cash: $8,200 (7677% of Medicare)
Ins. Median: $126 (118% 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
Humana $68 - $206 64%
Medicaid / KanCare $68 - $72 64%
UnitedHealthcare $69 - $103 65%
Veterans Administration Mill Bill $72 67%
Medicare (plans) $93 - $225 87%
Aetna $103 - $6,150 96%
Devoted Health $103 96%
Leon Health Inc $103 96%
Tricare $104 97%
Catholic Hospice $105 98%
Employer Direct Healthcare $105 - $164 98%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $105 98%
Hospice Other $105 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $105 98%
Opus Care Of South Florida $105 98%
Seasons Hospice And Palliative Care Of Southern Florida Inc $105 98%
Veterans Administration Vaccn $105 98%
Vitas Healthcare Corporation/Hospice Ppo $105 98%
Cigna $108 - $2,411 101%
Healthsun Health Plans $108 - $136 101%
Longevity Health Plan $109 102%
Avmed Broad Network $120 112%
Florida Pace Centers $124 116%
Bright Health Management Commercial $126 118%
Self Pay/Uninsured $129 - $161 121%
Naphcare Inc $144 135%
Dimension Health Wc $146 137%
Workers Compensation $146 137%
Imagine Health $153 143%
Avmed Exchange $183 171%
Oscar Health Plan Hix $188 176%
Ambetter / Centene $194 182%
Molina Marketplace Program Exchange $199 186%
Auto Insurance $209 196%
Avmed Select Network $214 200%
Amerihealth Caritas Next Exchange $225 211%
Bc/Bs Of Fl Miami Dade Blue Select $258 242%
Bc/Bs Of Fl Network Blue $328 307%
Bc/Bs Of Fl Health Options Hmo $330 309%
Bc/Bs Myblue Hmo Hix $339 317%
Bc/Bs Of Fl Simplyblue $356 333%
Bc/Bs Of Fl Blue Select Exchange Non Par $360 337%
Bc/Bs Of Fl Ppo $384 360%
Bc/Bs Of Fl Phs $4,404 4123%
Dimension International $5,330 4990%
First Health $5,822 5451%
Dimension Health Ppo $6,150 5758%
Commercial Non-Contracted $8,200 7677%
Self Pay - Mcd Pending 100 Percent $8,200 7677%
Single Case Agreement $8,200 7677%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals