CMS Price Transparency Data

CT scan, head (with contrast)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $2,857
  • Cash Discount Price: $2,588
  • vs. Medicare Baseline: 15.94x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at HSHS St Elizabeth's Hospital is $2,857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,588. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 15.94x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$2,588

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,857

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: $2,588 (1444%)
Insurance Median: $2,857 (1594%)
Cash: $2,588 (1444% of Medicare)
Ins. Median: $2,857 (1594% 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 1594% of the Medicare baseline (a markup of 1494%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $199 - $2,530 111%
Blue Cross Blue Shield $199 - $3,594 111%
Clear Spring Health Of Illinois $199 111%
Health Alliance Medical Plans $199 - $3,055 111%
Health Partners $199 111%
Humana $199 111%
Sae Hospice $199 111%
UnitedHealthcare $199 - $3,594 111%
Molina Healthcare $208 - $277 116%
Meridian Health Plan $290 162%
Celtic Insurance Company $397 222%
Naphcare $431 241%
Hopetrust $477 266%
Claim Doc $497 277%
Amish Community $1,006 561%
Cigna $2,290 - $3,594 1278%
Wellfirst $2,314 1291%
First Health $2,674 1492%
Healthlink $2,857 - $3,594 1594%
Caterpillar, Inc. $2,886 1610%
Consociate Group $3,163 1765%
Choicecare $3,235 1805%
Healthcare Finest Network (Hfn) $3,235 1805%
Multiplan/Phcs $3,235 1805%
Provider Network Of America $3,235 1805%
City Of Springfield $3,594 2006%
Current Health Solutions $3,594 2006%
Healthscope $3,594 2006%
Illinois Breast And Cervical Cancer Program $3,594 2006%
Interplan $3,594 2006%
Live360 $3,594 2006%
Wexford $3,594 2006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals