CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Mc Donough District Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $376
Cash Discount Price: $945
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Mc Donough District Hospital is $376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $945. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.10x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$945

Average discount available for prompt cash payment at this facility.

Insurance Median

$376

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: $945 (527%)

Insurance Median: $376 (210%)

Cash: $945 (527% of Medicare)

Ins. Median: $376 (210% 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 210% of the Medicare baseline (a markup of 110%). 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	$34 - $2,431	19%
Hfn	$54 - $2,459	30%
UnitedHealthcare	$54 - $2,459	30%
Aetna	$57 - $2,732	32%
Humana	$57 - $2,459	32%
Medicaid / KanCare	$57 - $2,732	32%
Medicare (plans)	$57 - $199	32%
Meridian	$57 - $199	32%
Molina	$57 - $2,732	32%
Mutual Medical	$57 - $2,732	32%
Veteran Affairs	$57 - $199	32%
Tricare	$186	104%
Springfield Health	$343 - $2,240	191%
Consociate	$355 - $2,322	198%
Trilogy	$355 - $2,322	198%
Blue Choice	$376 - $2,459	210%
Current Health	$376 - $2,459	210%
Healthlink	$376 - $2,568	210%
Blue Cross Blue Shield	$382 - $2,732	213%
Preferred Plan	$397 - $2,595	222%

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 $945.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

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 70470.
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.