CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida West Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,718
Cash Discount Price: $5,001
vs. Medicare Baseline: 16.08x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida West Hospital is $1,718. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,001. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.08x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.

Cash / Self-Pay

$5,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,718

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: $5,001 (4682%)

Insurance Median: $1,718 (1608%)

Cash: $5,001 (4682% of Medicare)

Ins. Median: $1,718 (1608% 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 1608% of the Medicare baseline (a markup of 1508%). 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
Freedom Health	$221 - $1,015	207%
United	$245 - $3,598	229%
Simply	$268 - $1,231	251%
Molina Healthcare	$330 - $2,558	309%
Sunshine State Health Plan	$443 - $2,039	415%
Aetna	$522 - $2,399	489%
Avmed	$870 - $3,998	815%
Plotkin Health	$870 - $3,998	815%
Prime Health Sheriff	$870 - $3,998	815%
Evolutions Healthcare	$1,130 - $6,796	1058%
Multiplan	$1,356 - $6,796	1270%
Evernorth	$1,391 - $6,396	1302%
Ppo Next	$1,478 - $6,796	1384%
Novanet	$1,565 - $7,196	1465%
Beacon Health Options	$1,739 - $7,995	1628%
Corvel Corporation	$1,908	1786%
Prime Health	$1,948	1824%
Careworks (Rockport Community)	$2,008	1880%

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 $5,001.
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 West 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.