CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Sarah D Culbertson Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,357
Cash Discount Price: $1,768
vs. Medicare Baseline: 7.57x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Sarah D Culbertson Memorial Hospital is $1,357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,768. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.57x the Medicare baseline. Located in 238 South Congress Street, Rushville, IL.

Cash / Self-Pay

$1,768

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,357

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: $1,768 (987%)

Insurance Median: $1,357 (757%)

Cash: $1,768 (987% of Medicare)

Ins. Median: $1,357 (757% 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 757% of the Medicare baseline (a markup of 657%). 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	$58 - $2,989	32%
Blue Cross Blue Shield	$58 - $3,255	32%
Molina Mmai-All Other Plans	$58 - $1,428	32%
UnitedHealthcare	$58 - $2,989	32%
Cigna	$70 - $2,454	39%
Multiplan/Phcs-All Plans	$175 - $2,989	98%
Meridian Hp Mcaid-All Plans	$186 - $993	104%
Molina Healthcare Mcaid	$186 - $993	104%
Health Dynamics-All Plans	$486 - $2,989	271%
Healthlink-All Plans	$500	279%
Preferred Medical Claims Solution-All Plans	$546 - $2,989	305%
Three Rivers Provider Network-All Plans	$546 - $2,989	305%
Corvel-All Plans	$993	554%
Humana	$1,428	797%
Beech Street-All Plans	$2,989	1668%
Encompass-All Plans	$2,989	1668%
Hfn Epo	$2,989	1668%
Hfn Ppo Ip/Op Only-All Other Plans	$2,989	1668%
Wexford Ip/Op Only-All Plans	$2,989	1668%
Healthsmart-All Plans	$3,155	1761%

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 $1,768.
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 Sarah D Culbertson 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.