CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Sanford Sheldon Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,045
Cash Discount Price: $2,536
vs. Medicare Baseline: 11.41x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Sanford Sheldon Medical Center is $2,045. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,536. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 11.41x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.

Cash / Self-Pay

$2,536

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,045

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: $2,536 (1415%)

Insurance Median: $2,045 (1141%)

Cash: $2,536 (1415% of Medicare)

Ins. Median: $2,045 (1141% 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 1141% of the Medicare baseline (a markup of 1041%). 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
Sanford Health Plan Align	$903	504%
Ucare	$970 - $2,785	541%
Aetna	$980 - $2,755	547%
Blue Cross Blue Shield	$980	547%
Health Partners	$980 - $2,378	547%
Medicare (plans)	$980	547%
UnitedHealthcare	$980 - $2,647	547%
Primewest	$999	557%
Wellmark	$1,585 - $1,648	884%
Sanford Health Plan	$1,698 - $1,998	948%
Security Health Plan	$1,744	973%
Medica	$2,615 - $2,796	1459%
First Choice Health Network	$2,853	1592%
Healthez	$2,853	1592%
Multiplan	$2,853	1592%

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 $2,536.
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 Sanford Sheldon Medical Center 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.