CMS Price Transparency Data

CT scan, sinuses

Facility: HCA Florida Palms West Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,228
Cash Discount Price: $12,798
vs. Medicare Baseline: 20.86x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at HCA Florida Palms West Hospital is $2,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,798. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.86x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

$12,798

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,228

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: $12,798 (11982%)

Insurance Median: $2,228 (2086%)

Cash: $12,798 (11982% of Medicare)

Ins. Median: $2,228 (2086% 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 2086% of the Medicare baseline (a markup of 1986%). 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 - $5,759	229%
Healthy Palm Beaches	$550	515%
Aetna	$868 - $3,839	813%
Avmed	$890 - $6,399	833%
Freedom Health	$1,101 - $2,048	1031%
Optimum	$1,101	1031%
Simply Healthcare Plans	$1,664	1558%
Corvel Corporation	$2,084	1951%
Careworks (Rockport)	$2,128	1992%
Prime Health	$2,128	1992%
Molina	$2,432 - $3,455	2277%
Health Sun Health Plan	$2,726	2552%
Aids Healthcare	$2,816 - $15,358	2636%
Mmm Of Fl (Health Advantage Plan)	$2,944	2756%
United Ppo	$3,033	2840%
Sunshine State Health Plan	$3,327	3115%
Health Care District	$6,399	5991%
Palm Beach Juvenile Correction	$6,399	5991%
Plotkin Health	$6,399	5991%
Prime Health Sherriff	$6,399	5991%
Medica Healthcare	$7,423	6950%
Multiplan	$9,598 - $10,878	8986%

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 $12,798.
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 Palms 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.