CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Mc Donough District Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $332
Cash Discount Price: $1,053
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Mc Donough District Hospital is $332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,053. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.85x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$1,053

Average discount available for prompt cash payment at this facility.

Insurance Median

$332

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: $1,053 (588%)

Insurance Median: $332 (185%)

Cash: $1,053 (588% of Medicare)

Ins. Median: $332 (185% 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.

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	$31 - $2,795	17%
Hfn	$48 - $2,826	27%
UnitedHealthcare	$48 - $2,826	27%
Aetna	$51 - $3,140	28%
Humana	$51 - $2,826	28%
Medicaid / KanCare	$51 - $3,140	28%
Medicare (plans)	$51 - $199	28%
Meridian	$51 - $199	28%
Molina	$51 - $3,140	28%
Mutual Medical	$51 - $3,140	28%
Veteran Affairs	$51 - $199	28%
Tricare	$186	104%
Springfield Health	$303 - $2,575	169%
Consociate	$314 - $2,669	175%
Trilogy	$314 - $2,669	175%
Blue Choice	$332 - $2,826	185%
Current Health	$332 - $2,826	185%
Healthlink	$332 - $2,952	185%
Preferred Plan	$351 - $2,983	196%
Blue Cross Blue Shield	$369 - $3,140	206%

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 $1,053.
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 Mc Donough District 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.