CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Fishermen's Community Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $3,775
  • Cash Discount Price: $4,336
  • vs. Medicare Baseline: 21.07x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Fishermen's Community Hospital is $3,775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,336. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 21.07x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$4,336

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,775

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Cash / Self-Pay: $4,336 (2420%)
Insurance Median: $3,775 (2107%)
Cash: $4,336 (2420% of Medicare)
Ins. Median: $3,775 (2107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 2107% of the Medicare baseline (a markup of 2007%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup $197 110%
Medicaid / KanCare $197 - $217 110%
UnitedHealthcare $197 - $6,670 110%
Wellcare $207 116%
Sunshine State $209 117%
Aetna $213 - $5,109 119%
Vista $213 119%
Blue Cross Blue Shield $1,114 - $6,670 622%
Leon Medical $1,401 782%
Medica Health Plan $1,401 782%
Medicare (plans) $1,401 - $1,891 782%
Humana $1,527 852%
Avmed $1,541 - $5,523 860%
Cigna $1,597 - $5,336 891%
Non Contracted $2,448 1366%
International $4,336 2420%
Amerihealth $5,002 2791%
Dimension Health Plan $5,002 - $6,003 2791%
Affordable $6,003 3350%
Phcs $6,003 3350%
Quality Health $6,003 3350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals