CMS Price Transparency Data

CT scan, sinuses

Facility: Sarasota Memorial Hospital - Venice

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,472
Cash Discount Price: $1,635
vs. Medicare Baseline: 13.78x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Sarasota Memorial Hospital - Venice is $1,472. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,635. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.78x the Medicare baseline. Located in 2600 Laurel Road East, North Venice, FL.

Cash / Self-Pay

$1,635

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,472

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: $1,635 (1531%)

Insurance Median: $1,472 (1378%)

Cash: $1,635 (1531% of Medicare)

Ins. Median: $1,472 (1378% 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 1378% of the Medicare baseline (a markup of 1278%). 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
Simply Healthcare	$67 - $71	63%
Sunshine State	$71	66%
Molina	$73	68%
Amerihealth Caritas	$74	69%
Community Care Plan	$74	69%
Florida Community Care	$74 - $117	69%
Blue Cross Blue Shield	$107	100%
Aetna	$110 - $3,737	103%
UnitedHealthcare	$110 - $3,508	103%
Simply Freedom Optimum	$112	105%
Wellcare	$112	105%
Ambetter / Centene	$288	270%
Careworks	$1,472 - $2,197	1378%
Enlyte	$1,472 - $2,197	1378%
Avmed	$2,558 - $3,410	2395%
Usa Managed Care	$2,803 - $3,737	2624%
First Health	$2,908 - $3,877	2723%

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 $1,635.
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 Sarasota Memorial Hospital - Venice 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.