CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Fayette County Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $599
Cash Discount Price: $1,863
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Fayette County Hospital is $599. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,863. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.34x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$1,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$599

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: $1,863 (1040%)

Insurance Median: $599 (334%)

Cash: $1,863 (1040% of Medicare)

Ins. Median: $599 (334% 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 334% of the Medicare baseline (a markup of 234%). 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
Health Alliance Mcare	$52 - $1,095	29%
Healthlink Mcr Adv	$52 - $1,095	29%
Aetna	$57 - $2,360	32%
Cigna	$60 - $2,566	33%
Coventry/Ghp-All Plans	$71 - $2,224	40%
Multiplan - All Plans	$97 - $2,908	54%
Health Alliance - All Other Plans	$105 - $2,826	59%
Blue Cross Blue Shield	$125 - $2,874	70%
UnitedHealthcare	$253 - $2,839	141%
Healthlink Hmo	$262 - $2,395	146%
Healthlink Ppo - All Other Plans	$262 - $2,737	146%
Illinicare - All Plans	$326 - $599	182%
Medicaid / KanCare	$326 - $599	182%
Meridian-All Plans	$326 - $599	182%
Humana	$1,095	611%

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 $1,863.
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 Fayette County 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.