CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida North Florida Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $3,190
Cash Discount Price: $10,290
vs. Medicare Baseline: 29.87x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida North Florida Hospital is $3,190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,290. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 29.87x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$10,290

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,190

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: $10,290 (9634%)

Insurance Median: $3,190 (2987%)

Cash: $10,290 (9634% of Medicare)

Ins. Median: $3,190 (2987% 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 2987% of the Medicare baseline (a markup of 2887%). 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 - $4,630	229%
Avmed	$857 - $5,145	802%
Aetna	$968 - $3,087	906%
Simply	$1,585	1484%
Molina Healthcare	$1,955 - $3,293	1830%
Corvel Corporation	$2,097	1963%
Prime Health	$2,141	2004%
Careworks (Rockport Community)	$2,207	2066%
Sunshine State Health Plan	$2,624	2457%
Plotkin Health	$5,145	4817%
Prime Health Sheriff	$5,145	4817%
Corizon Phs	$6,174	5780%
Multiplan	$8,026 - $8,746	7514%
Evernorth	$8,232	7707%
Evolutions Healthcare	$8,746	8188%
Ppo Next	$8,746	8188%
Novanet	$9,261	8671%
Beacon Health Options	$10,290	9634%

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 $10,290.
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 North Florida 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.