CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Gulf Coast Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $5,453
Cash Discount Price: $12,118
vs. Medicare Baseline: 51.05x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Gulf Coast Hospital is $5,453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,118. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 51.05x the Medicare baseline. Located in 449 W 23Rd St, Panama City, FL.

Cash / Self-Pay

$12,118

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,453

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: $12,118 (11345%)

Insurance Median: $5,453 (5105%)

Cash: $12,118 (11345% of Medicare)

Ins. Median: $5,453 (5105% 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 5105% of the Medicare baseline (a markup of 5005%). 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 - $5,478	229%
Aetna	$1,258 - $3,652	1178%
Avmed	$1,695 - $6,087	1587%
Corvel Corporation	$1,849	1731%
Simply	$1,865 - $1,875	1746%
Prime Health	$1,888	1768%
Careworks (Rockport Community)	$1,946	1822%
Molina Healthcare	$2,301 - $3,896	2154%
Sunshine State Health Plan	$3,089 - $3,104	2892%
Plotkin Health	$6,056 - $6,087	5670%
Prime Health Sheriff	$6,056 - $6,087	5670%
Multiplan	$9,448 - $10,348	8846%
Ppo Next	$10,296 - $10,348	9640%
Novanet	$10,901 - $10,957	10206%

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 $12,118.
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 Gulf Coast 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.