CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Northwest Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,841
Cash Discount Price: $7,027
vs. Medicare Baseline: 17.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Northwest Hospital is $1,841. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,027. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.24x the Medicare baseline. Located in 2801 N State Rd 7, Margate, FL.

Cash / Self-Pay

$7,027

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,841

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: $7,027 (6579%)

Insurance Median: $1,841 (1724%)

Cash: $7,027 (6579% of Medicare)

Ins. Median: $1,841 (1724% 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 1724% of the Medicare baseline (a markup of 1624%). 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 - $3,162	229%
Freedom Health	$604 - $1,124	565%
Optimum	$604	565%
Aetna	$769 - $2,108	720%
Avmed	$890 - $3,514	833%
Simply Healthcare Plans	$914	856%
Molina	$1,335 - $1,897	1250%
Health Sun Health Plan	$1,497	1402%
Mmm Of Fl (Health Advantage Plan)	$1,616	1513%
United Ppo	$1,665	1559%
Sunshine State Health Plan	$1,855	1737%
Corvel Corporation	$2,182	2043%
Careworks (Rockport)	$2,228	2086%
Prime Health	$2,228	2086%
Blis	$2,459	2302%
Plotkin Health	$3,514	3290%
Prime Health Sherriff	$3,514	3290%
Medica Healthcare	$4,076	3816%
Multiplan	$5,270 - $5,973	4934%

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 $7,027.
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 Northwest 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.