CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Orange Park Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $5,151
Cash Discount Price: $17,168
vs. Medicare Baseline: 48.23x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Orange Park Hospital is $5,151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,168. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 48.23x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$17,168

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,151

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: $17,168 (16073%)

Insurance Median: $5,151 (4823%)

Cash: $17,168 (16073% of Medicare)

Ins. Median: $5,151 (4823% 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 4823% of the Medicare baseline (a markup of 4723%). 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 - $7,726	229%
Aetna	$716 - $5,151	670%
Avmed	$825 - $1,863	772%
Optimum Healthcare	$1,442	1350%
Corvel Corporation	$1,985	1858%
Prime Health	$2,026	1897%
Simply Healthcare	$2,644	2475%
Positive Healthcare	$3,777	3536%
Sunshine State Health Plan	$4,378	4099%
Molina Healthcare	$4,635 - $4,636	4339%
Medicare (plans)	$7,725 - $7,726	7232%
Plotkin Health	$8,584 - $8,585	8037%
Multiplan	$13,390 - $14,594	12536%
Evernorth	$13,734 - $13,735	12858%
Evolutions Healthcare	$13,734 - $14,594	12858%
Ppo Next	$14,592 - $14,594	13662%
Novanet	$15,450 - $15,452	14465%

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 $17,168.
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 Orange Park 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.