CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Adventist Health Sierra Vista

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,549
Cash Discount Price: $623
vs. Medicare Baseline: 14.22x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Adventist Health Sierra Vista is $2,549. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 14.22x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$623

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,549

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: $623 (348%)

Insurance Median: $2,549 (1422%)

Cash: $623 (348% of Medicare)

Ins. Median: $2,549 (1422% 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 1422% of the Medicare baseline (a markup of 1322%). 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
Aetna	$225	126%
Cencal Mcr Adv - All Other Plans	$225	126%
Tricare	$225	126%
UnitedHealthcare	$225 - $2,383	126%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$293	164%
Ah Employee Health Plan - All Plans	$405	226%
Hpn-Heritage Prov Ntwrk-All Plans	$2,355	1314%
Blue Shield Epn	$2,715	1515%
Blue Shield Hmo/Pos	$3,380	1886%
Blue Shield Epo/Ppo-All Other Plans	$3,727	2080%
Nbd-Ntwrks By Design Exclus-All Other Plans	$4,000	2232%
Nbd-Ntwrks By Design Non-Exclus	$4,000	2232%
Medi-Cal	$6,927	3866%
Cencal Mcal	$7,897	4407%
Blue Shield Promise Mcal	$8,326	4646%
Ccah-Centrl Ca Allince Mcal-All Plans	$9,005	5025%
Coalinga-All Plans	$9,005	5025%

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 $623.
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 Sierra Vista 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.