CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Anderson Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,265
Cash Discount Price: $1,605
vs. Medicare Baseline: 7.06x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Anderson Hospital is $1,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,605. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.06x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$1,605

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,265

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: $1,605 (896%)

Insurance Median: $1,265 (706%)

Cash: $1,605 (896% of Medicare)

Ins. Median: $1,265 (706% 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 706% of the Medicare baseline (a markup of 606%). 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 Care Service Corporation	$113 - $1,469	63%
Tricare	$138 - $5,697	77%
Humana	$141 - $4,777	79%
Medicare (plans)	$141 - $4,777	79%
UnitedHealthcare	$141 - $4,777	79%
Aetna	$185 - $4,777	103%
Essence	$188 - $5,020	105%
Devoted Health Ppo	$189 - $4,872	105%
Clear Springs Health	$190 - $4,920	106%
Ambetter / Centene	$273 - $7,067	152%
Blue Choice	$273 - $7,067	152%
Medicaid / KanCare	$304 - $382	170%
Mercy Benefit Admin	$311	174%
Mercy Aco	$318	177%
Hopetrust	$470 - $12,184	262%
Healthlink	$1,198 - $1,265	669%
Work Comp	$1,578 - $26,600	881%
Self Pay	$1,605 - $25,000	896%
Blue Cross Blue Shield	$1,722 - $1,784	961%
Cigna	$2,248	1254%
Multiplan/Phcs	$2,408	1344%
Beech Street Corporation	$2,890	1613%

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 $1,605.
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 Anderson 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.