CMS Price Transparency Data

CT scan, sinuses

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $165
  • Cash Discount Price: $1,991
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Physicians Regional Medical Center - Pine Ridge is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,991. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.54x the Medicare baseline. Located in 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
$1,991

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $1,991 (1864%)
Insurance Median: $165 (154%)
Cash: $1,991 (1864% of Medicare)
Ins. Median: $165 (154% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Childrens Medical Services $67 63%
Medicaid / KanCare $67 - $74 63%
UnitedHealthcare $67 - $2,141 63%
Humana $69 - $107 65%
Integral Health $71 66%
Wellcare $71 66%
Simply Healthcare Plan $72 67%
Magellan $73 68%
Amerigroup $74 69%
Prestige Health $78 73%
Veterans Eval Services $100 94%
Tricare $104 97%
Aetna $107 - $5,875 100%
Blue Cross Blue Shield $107 - $2,552 100%
Medicare (plans) $107 100%
Node Champva $109 102%
Node Non Par Hospice Agree $109 102%
Node Va $109 102%
Freedom Optimum $111 104%
Node Wellcare Mcr Adv $112 105%
Node Us Dept Of Labor $136 127%
Occunet $158 - $1,250 148%
Prime Health Work Comp Fl $171 160%
Rockport $171 160%
Florida Workers Compensation $176 165%
Florida State Auto Insurance $218 204%
Ambetter / Centene $278 260%
Cigna $392 367%
Community Health Partners $562 526%
Self Pay $1,593 - $2,124 1491%
Simply Healthcare $2,743 2568%
Avmed $3,362 3148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals