CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,743
Cash Discount Price: $3,502
vs. Medicare Baseline: 20.89x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Memorial Hospital is $3,743. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,502. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 20.89x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$3,502

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,743

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: $3,502 (1954%)

Insurance Median: $3,743 (2089%)

Cash: $3,502 (1954% of Medicare)

Ins. Median: $3,743 (2089% 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 2089% of the Medicare baseline (a markup of 1989%). 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
Aetna	$558 - $4,157	311%
Consociate	$558 - $3,721	311%
Cigna	$1,000 - $3,326	558%
Humana	$1,094 - $4,378	610%
Blue Cross Blue Shield	$1,226 - $4,157	684%
Health Alliance	$1,226 - $4,378	684%
Meridian	$1,226 - $4,378	684%
Molina	$1,226 - $4,378	684%
UnitedHealthcare	$1,226 - $4,378	684%
First Health Network	$1,374 - $3,896	767%
Healthlink	$3,300 - $3,721	1842%
Private Healthcare Systems	$3,721	2076%
Integrated Health Plan	$3,853	2150%
Health Dynamics	$3,940	2199%
Health Payors Org	$3,940	2199%
Iowa Health Solutions	$3,940	2199%
Multiplan	$3,940	2199%
Preferred Plan Inc	$3,940	2199%
Three Rivers Provider Network	$3,940	2199%
Health First Network	$3,984	2223%
Pponext	$3,984	2223%
Corvel	$4,159	2321%

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 $3,502.
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 Memorial 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.