CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Hamilton Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,576
Cash Discount Price: $1,828
vs. Medicare Baseline: 8.79x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Hamilton Memorial Hospital is $1,576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,828. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 8.79x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.

Cash / Self-Pay

$1,828

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,576

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: $1,828 (1020%)

Insurance Median: $1,576 (879%)

Cash: $1,828 (1020% of Medicare)

Ins. Median: $1,576 (879% 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 879% of the Medicare baseline (a markup of 779%). 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	$141 - $1,935	79%
Blue Cross Blue Shield	$141 - $1,957	79%
Health Alliance	$141 - $1,720	79%
Medicare (plans)	$141 - $860	79%
UnitedHealthcare	$141 - $1,540	79%
Wellcare	$141 - $860	79%
Healthlink	$787 - $910	439%
Medicaid / KanCare	$800 - $860	446%
Alliance Coal	$860	480%
Humana	$860	480%
Healthscope	$1,505	840%
Wellfirst (Ssmhic)	$1,505	840%
Hope Trust	$1,613	900%
Cigna	$1,688	942%
Hfn, Inc	$1,720 - $1,935	960%
Multiplan	$1,828	1020%
Siho	$1,935	1080%
Three Rivers Provider	$1,935	1080%
Healthsmart	$2,043	1140%
Stratose	$2,043	1140%

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 $1,828.
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 Hamilton Memorial 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.