CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Mc Donough District Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $265
Cash Discount Price: $592
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Mc Donough District Hospital is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $592. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.48x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$592

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $592 (554%)

Insurance Median: $265 (248%)

Cash: $592 (554% of Medicare)

Ins. Median: $265 (248% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 248% of the Medicare baseline (a markup of 148%). 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
Health Alliance	$23 - $1,495	22%
Hfn	$36 - $1,512	34%
UnitedHealthcare	$36 - $1,512	34%
Aetna	$38 - $1,680	36%
Humana	$38 - $1,512	36%
Medicaid / KanCare	$38 - $1,680	36%
Medicare (plans)	$38 - $119	36%
Meridian	$38 - $119	36%
Molina	$38 - $1,680	36%
Mutual Medical	$38 - $1,680	36%
Veteran Affairs	$38 - $119	36%
Tricare	$111	104%
Springfield Health	$241 - $1,378	226%
Consociate	$250 - $1,428	234%
Trilogy	$250 - $1,428	234%
Blue Choice	$265 - $1,512	248%
Current Health	$265 - $1,512	248%
Healthlink	$265 - $1,579	248%
Preferred Plan	$279 - $1,596	261%
Blue Cross Blue Shield	$294 - $1,680	275%

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 $592.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mc Donough District Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.