CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Adventist Health Clearlake

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $3,586
Cash Discount Price: $1,716
vs. Medicare Baseline: 20.01x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Adventist Health Clearlake is $3,586. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,716. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 20.01x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$1,716

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,586

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: $1,716 (958%)

Insurance Median: $3,586 (2001%)

Cash: $1,716 (958% of Medicare)

Ins. Median: $3,586 (2001% 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 2001% of the Medicare baseline (a markup of 1901%). 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	$217	121%
Medi-Cal	$217	121%
Blue Cross Blue Shield	$838 - $1,142	468%
Blue Shield Mcr Adv	$903 - $1,099	504%
Kaiser Mcr Adv	$903 - $1,099	504%
Tricare	$903 - $1,099	504%
UnitedHealthcare	$993 - $4,363	554%
Ah Employee Health Plan - All Plans	$1,806 - $2,197	1008%
Blue Shield Epn - All Other Plans	$2,090	1166%
Blue Shield Non-Epn	$2,189	1222%
Aetna	$3,213 - $3,909	1793%
Western Growers- All Plans	$3,225 - $3,923	1800%
First Health- All Plans	$3,440 - $4,185	1920%
Healthnet- All Plans	$3,526 - $4,289	1968%
Foundation- All Plans	$3,655 - $4,446	2040%
Health Mgmt Network- All Plans	$3,655 - $4,446	2040%
Humana	$3,655 - $4,446	2040%
Phcs- All Plans	$3,655 - $4,446	2040%
Cigna	$3,870 - $4,708	2160%
Interplan- All Plans	$3,870 - $4,708	2160%
Kaiser- All Other Plans	$3,870 - $4,708	2160%
Three Rivers Provider Network- All Plans	$3,870 - $4,708	2160%
Partnership Mcal - All Plans	$7,095 - $8,631	3959%

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 $1,716.
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 Clearlake 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.