CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Boone County Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $963
Cash Discount Price: $1,679
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Boone County Hospital is $963. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,679. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.37x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$1,679

Average discount available for prompt cash payment at this facility.

Insurance Median

$963

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: $1,679 (937%)

Insurance Median: $963 (537%)

Cash: $1,679 (937% of Medicare)

Ins. Median: $963 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Tricare	$179	100%
Choice Care Mcr Adv - All Plans	$861	480%
Humana	$861 - $1,889	480%
Iowa Hlth Adv - All Plans	$861	480%
Mt Carmel Hp - All Plans	$861	480%
UnitedHealthcare	$861 - $1,232	480%
Va Ccn-All Plans	$861	480%
Amerigroup Mcr Adv - All Other Plans	$869	485%
Aetna	$880 - $1,637	491%
Wellmark Hmo	$882	492%
Meridian Mcaid - All Plans	$945	527%
Iowa Total Care Mcaid - All Plans	$963	537%
Wellmark Ppo - All Other Plans	$969	541%
Medicaid / KanCare	$973	543%
Healthsmart Accell Network	$1,469	820%
Medical Associates Hp-All Plans	$1,574	878%
Healthsmart Ppo - All Other Plans	$1,679	937%
Health Alliance-All Plans	$1,889	1054%
Midlands Choice-All Plans	$1,931	1078%
Mutually Preferred-All Plans	$1,994	1113%

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 $1,679.
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 Boone County Hospital 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.