CMS Price Transparency Data

CT scan, head (with contrast)

Facility: St Luke's McCall

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,051
Cash Discount Price: $1,455
vs. Medicare Baseline: 5.86x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at St Luke's McCall is $1,051. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,455. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.86x the Medicare baseline. Located in 1000 State Street, McCall, ID.

Cash / Self-Pay

$1,455

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,051

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: $1,455 (812%)

Insurance Median: $1,051 (586%)

Cash: $1,455 (812% of Medicare)

Ins. Median: $1,051 (586% 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 586% of the Medicare baseline (a markup of 486%). 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
Commercial [1028]	$634 - $1,743	354%
Medicare (plans)	$634 - $1,074	354%
Veterans Affairs [1056]	$634 - $1,053	354%
Blue Cross Blue Shield	$640 - $1,598	357%
Aetna	$697 - $1,725	389%
Moda [1055]	$962 - $1,598	537%
Cigna	$1,016 - $1,689	567%
Providence [1022]	$1,016 - $1,689	567%
Pacificsource [1020]	$1,027 - $1,707	573%
First Health [1064]	$1,038 - $1,725	579%
Webtpa [1071]	$1,038 - $1,725	579%
Geha [1065]	$1,049 - $1,743	585%
United Medical Resources [1051]	$1,049 - $1,743	585%
UnitedHealthcare	$1,049 - $1,743	585%

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 $1,455.
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 St Luke's McCall 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.