CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Adventist Health Reedley

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $210
Cash Discount Price: $437
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Adventist Health Reedley is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $437. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.17x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$437

Average discount available for prompt cash payment at this facility.

Insurance Median

$210

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: $437 (244%)

Insurance Median: $210 (117%)

Cash: $437 (244% of Medicare)

Ins. Median: $210 (117% 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.

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 - $2,855	17%
Blue Shield Mcare	$53 - $226	30%
Fhcn Pace Mcr Adv-All Plans	$53 - $226	30%
Lasalle Med Assoc Profee Only - All Plans	$53	30%
Tricare	$53 - $226	30%
UnitedHealthcare	$53 - $1,847	30%
Upn Mcr Adv Profee Only	$53	30%
Ah Employee Health Plan - All Plans	$58 - $406	32%
Community Care Ipa Mcal-All Plans	$63 - $282	35%
Kaiser - All Other Plans	$71 - $2,196	40%
Kaiser Mcr Adv	$71 - $226	40%
Healthnet- All Other Plans	$77 - $1,911	43%
Western Growers/Pinnacle- All Plans	$79 - $2,021	44%
Blue Shield Epn - All Other Plans	$97 - $1,942	54%
Blue Cross Blue Shield	$99 - $1,402	55%
Blue Shield Non Epn	$103 - $2,249	57%
Bc Mcal	$133 - $143	74%
Cal Viva Hlth Mcal - All Plans	$143 - $217	80%
Central Ca Alliance Mcal Profee Only	$143	80%
Dignity Mcal Op/Profee Only-All Other Plans	$143 - $238	80%
Medi-Cal	$143 - $217	80%
Upn Mcal Profee Only-All Other Plans	$143	80%
Physicians Med Group Op/Profee Only- All Plans	$168 - $3,514	94%
Kern Health Systems Mcal-All Plans	$179 - $217	100%
Aetna	$184 - $2,199	103%
Central Ca Alliance Ccs Profee Only	$210	117%
Central Ca Alliance Chdp Profee Only	$210	117%
Central Ca Alliance Comm Profee Only - All Other P	$210	117%
Dignity Mcr Adv Op/Profee Only	$226	126%
Healthnet- Mcr Adv	$226	126%
Phs Prime Health Srvcs	$226	126%
Bright Health Mcr Adv - All Plans	$354	198%
Healthnet Medi-Cal	$596	333%

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 $437.
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 Reedley 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.