CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Valley West Community Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,439
Cash Discount Price: $3,757
vs. Medicare Baseline: 19.19x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Valley West Community Hospital is $3,439. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,757. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 19.19x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.

Cash / Self-Pay

$3,757

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,439

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: $3,757 (2097%)

Insurance Median: $3,439 (1919%)

Cash: $3,757 (2097% of Medicare)

Ins. Median: $3,439 (1919% 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 1919% of the Medicare baseline (a markup of 1819%). 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
Blue Cross Blue Shield	$1,020 - $4,385	569%
Global Excel [1712]	$1,020	569%
Humana	$1,020	569%
Aetna	$1,363 - $3,719	761%
Health'S Finest Network [126]	$2,415 - $4,562	1348%
The Alliance [1703]	$2,917	1628%
Choicecare [177]	$3,617	2018%
Healthlink [125]	$4,025	2246%
Multiplan/Phcs [142]	$4,294 - $5,367	2396%
First Health Plan [6034]	$5,367	2995%
UnitedHealthcare	$5,367	2995%

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 $3,757.
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 Valley West Community 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.