CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Adventist Health Clearlake

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,924
Cash Discount Price: $1,820
vs. Medicare Baseline: 21.90x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Adventist Health Clearlake is $3,924. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,820. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 21.90x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$1,820

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,924

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: $1,820 (1016%)

Insurance Median: $3,924 (2190%)

Cash: $1,820 (1016% of Medicare)

Ins. Median: $3,924 (2190% 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 2190% of the Medicare baseline (a markup of 2090%). 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
Bc Managed Mcal	$248	138%
Medi-Cal	$248	138%
Blue Shield Mcr Adv	$988 - $1,135	551%
Kaiser Mcr Adv	$988 - $1,135	551%
Tricare	$988 - $1,135	551%
Blue Cross Blue Shield	$1,028 - $1,394	574%
UnitedHealthcare	$1,087 - $4,509	607%
Ah Employee Health Plan - All Plans	$1,976 - $2,271	1103%
Blue Shield Epn - All Other Plans	$2,616	1460%
Blue Shield Non-Epn	$2,740	1529%
Aetna	$3,516 - $4,039	1962%
Western Growers- All Plans	$3,529 - $4,054	1969%
First Health- All Plans	$3,764 - $4,325	2100%
Healthnet- All Plans	$3,858 - $4,433	2153%
Foundation- All Plans	$3,999 - $4,595	2232%
Health Mgmt Network- All Plans	$3,999 - $4,595	2232%
Humana	$3,999 - $4,595	2232%
Phcs- All Plans	$3,999 - $4,595	2232%
Cigna	$4,234 - $4,865	2363%
Interplan- All Plans	$4,234 - $4,865	2363%
Kaiser- All Other Plans	$4,234 - $4,865	2363%
Three Rivers Provider Network- All Plans	$4,234 - $4,865	2363%
Partnership Mcal - All Plans	$7,763 - $8,920	4332%

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 $1,820.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Clearlake is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.