CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Adventist Health St Helena

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,864
Cash Discount Price: $881
vs. Medicare Baseline: 15.98x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Adventist Health St Helena is $2,864. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $881. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 15.98x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$881

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,864

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: $881 (492%)

Insurance Median: $2,864 (1598%)

Cash: $881 (492% of Medicare)

Ins. Median: $2,864 (1598% 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 1598% of the Medicare baseline (a markup of 1498%). 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
Cigna	$30 - $6,579	17%
Blue Shield Bh Mcr Adv	$57 - $233	32%
Blue Shield Mcr Adv	$57 - $233	32%
Kaiser Mcr Adv	$57 - $233	32%
Tricare	$57 - $233	32%
Ah Employee Health Plan - All Plans	$63 - $419	35%
Interplan-All Plans	$69 - $5,346	39%
Kaiser-All Other Plans	$69 - $6,744	39%
Western Growers-All Plans	$85 - $4,359	47%
Blue Shield Epn-All Other Plans	$104 - $3,874	58%
Blue Shield Non-Epn	$110 - $3,816	61%
Phcs-All Plans	$128 - $4,523	71%
Medi-Cal	$143	80%
Health Management Network-All Plans	$198 - $6,990	110%
UnitedHealthcare	$209 - $5,243	117%
Three Rivers-All Plans	$210 - $7,402	117%
Va Medi-Cal	$217	121%
Va Mcr - All Other Plans	$233	130%
Aetna	$316 - $1,316	176%
Blue Cross Blue Shield	$867 - $1,156	484%
Healthnet-All Plans	$1,060	592%
Blue Shield Behav Hlth	$1,983 - $3,701	1107%
Choicecare-All Plans	$3,084 - $5,757	1721%
Beech Street-All Plans	$3,304 - $6,168	1844%
Galaxy Network-All Plans	$3,965 - $7,402	2213%

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 $881.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
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.