CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Englewood Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,057
Cash Discount Price: $19,173
vs. Medicare Baseline: 19.26x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Englewood Hospital is $2,057. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,173. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.26x the Medicare baseline. Located in 700 Medical Blvd, Englewood, FL.

Cash / Self-Pay

$19,173

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,057

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: $19,173 (17951%)

Insurance Median: $2,057 (1926%)

Cash: $19,173 (17951% of Medicare)

Ins. Median: $2,057 (1926% 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 1926% of the Medicare baseline (a markup of 1826%). 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 - $8,628	229%
Avmed	$738 - $1,863	691%
Aetna	$848 - $5,752	794%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$901	844%
Access 2 Healthcare Physicians Freedom Health	$1,380	1292%
Access 2 Healthcare Physicians Optimum	$1,380	1292%
Freedom Health Care	$1,495	1400%
Optimum Healthcare	$1,495	1400%
Corvel Corporation	$2,015	1887%
Rockport Healthcare Group	$2,015	1887%
Prime Health	$2,057	1926%
Simply Healthcare	$2,953	2765%
Molina	$3,643 - $5,177	3411%
Sunshine State Health Plan	$4,889	4577%
Behealthy America	$7,477	7000%
Evolutions Healthcare Systems	$9,586 - $17,639	8975%
Plotkin Health	$9,586	8975%
Prime Health Sheriff	$9,586	8975%
Multiplan	$14,379 - $16,297	13462%

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 $19,173.
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 Englewood 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.