CMS Price Transparency Data

CT scan, sinuses

Facility: Ascension St Vincent's Clay County

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $122
  • Cash Discount Price: $601
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Ascension St Vincent's Clay County is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $601. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 1670 St Vincents Way, Middleburg, FL.
Cash / Self-Pay
$601

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $601 (563%)
Insurance Median: $122 (114%)
Cash: $601 (563% of Medicare)
Ins. Median: $122 (114% 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
Humana $104 - $108 97%
Bc Advantage Mcr Replacement $107 100%
Blue Cross Blue Shield $107 100%
Community Hospice $107 100%
Coventry Mcr Replacement Hmo $107 100%
Haven Hospice $107 100%
Medicare (plans) $107 - $109 100%
Research Study Encore Borland-Groover $107 100%
Veterans Administration $107 100%
Wellcare $107 100%
Cigna $108 - $601 101%
UnitedHealthcare $108 - $236 101%
Careplus Mcr Replacement $109 102%
Aetna $110 - $764 103%
Inmate Health Care $133 125%
Bright Health $144 - $155 135%
Smarthealth $149 140%
Oscar Health Plan $171 160%
Employer Direct Healthcare $187 175%
90 Degree Benefits $192 180%
Avmed Exchange $192 180%
Molina Exchange $197 184%
Occunet $197 - $240 184%
Ambetter / Centene $203 190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1670 St Vincents Way, Middleburg, FL 32068
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals