CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: St Joseph's Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $2,301
  • Cash Discount Price: $2,588
  • vs. Medicare Baseline: 12.84x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Joseph's Hospital is $2,301. 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 12.84x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$2,588

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,301

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: $2,301 (1284%)
Cash: $2,588 (1444% of Medicare)
Ins. Median: $2,301 (1284% 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 1284% of the Medicare baseline (a markup of 1184%). 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
Molina Healthcare $613 - $719 342%
Meridian Health Plan $642 358%
UnitedHealthcare $719 - $3,594 401%
Clear Spring Health of Illinois $719 401%
Humana $719 401%
Aetna $719 - $2,512 401%
Sae Hospice $719 401%
Blue Cross Blue Shield $719 401%
Amish Community $1,006 561%
Cigna $1,190 664%
Caterpillar, Inc. $1,315 734%
Naphcare $1,509 842%
Celtic Insurance Company $1,581 882%
Claim Doc $1,797 1003%
Hopetrust $1,797 1003%
Wellfirst $2,301 1284%
First Health $2,656 1482%
Multiplan/Phcs $3,055 1705%
Healthlink $3,055 1705%
Provider Network of America $3,235 1805%
Healthcare Finest Network (Hfn) $3,235 1805%
Interplan $3,594 2006%
Consociate Group $3,594 2006%
Illinois Breast and Cervical Cancer Program $3,594 2006%
Current Health Solutions $3,594 2006%
Healthscope $3,594 2006%
Mental Health Network $3,594 2006%
Qtc Medical Group of Illinois $3,594 2006%
Health Alliance Medical Plans $3,594 2006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals