CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida South Shore Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,957
Cash Discount Price: $9,342
vs. Medicare Baseline: 18.32x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida South Shore Hospital is $1,957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,342. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.32x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$9,342

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,957

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: $9,342 (8746%)

Insurance Median: $1,957 (1832%)

Cash: $9,342 (8746% of Medicare)

Ins. Median: $1,957 (1832% 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 1832% of the Medicare baseline (a markup of 1732%). 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 - $4,498	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$408 - $470	382%
Access 2 Healthcare Physicians Freedom Health	$626 - $720	586%
Access 2 Healthcare Physicians Optimum	$626 - $720	586%
Freedom Health Care	$678 - $780	635%
Optimum Healthcare	$678 - $780	635%
Avmed	$738 - $1,863	691%
Aetna	$913 - $2,998	855%
Simply Healthcare	$1,338 - $1,539	1253%
Molina	$1,651 - $2,699	1546%
Corvel Corporation	$2,015	1887%
Rockport Healthcare Group	$2,015	1887%
Prime Health	$2,057	1926%
Sunshine State Health Plan	$2,216 - $2,549	2075%
Plotkin Health	$4,345 - $4,997	4068%
Prime Health Sheriff	$4,345 - $4,997	4068%
Evolutions Healthcare Systems	$4,780 - $9,195	4475%
Multiplan	$6,518 - $8,496	6102%

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 $9,342.
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 South Shore 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.