CMS Price Transparency Data
CT scan, head (with and without contrast)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 70470 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70470
- Insurance Median: $2,339
- Cash Discount Price: $2,534
- vs. Medicare Baseline: 13.05x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Saint Joseph Regional Medical Center - Plymouth is $2,339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,534. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 13.05x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$2,534
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,339
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: $2,534 (1414%)
Insurance Median: $2,339 (1305%)
Cash: $2,534 (1414% of Medicare)
Ins. Median: $2,339 (1305% 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 1305% of the Medicare baseline (a markup of 1205%). 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 |
|---|---|---|
| Aetna | $96 - $2,534 | 54% |
| Blue Cross Blue Shield | $96 - $655 | 54% |
| Medicaid / KanCare | $96 - $378 | 54% |
| UnitedHealthcare | $96 - $878 | 54% |
| Medicare (plans) | $186 - $189 | 104% |
| Meridian Complete | $186 | 104% |
| Pace-Trinity Health | $186 | 104% |
| County Coroner | $193 | 108% |
| Provider Partners Health Plan Of Indiana | $204 | 114% |
| Auxiant | $278 - $3,235 | 155% |
| Physicians Health Plan Northern Indiana Health Insurance | $278 - $560 | 155% |
| St Joseph County Hlth Dpt | $278 | 155% |
| Caresource | $288 | 161% |
| Siho Insurance Services | $297 | 166% |
| Key Benefit Administrator | $334 - $2,733 | 186% |
| Allied Benefit Systems | $353 - $2,534 | 197% |
| Managed Health Services - Indiana | $378 | 211% |
| Mdwise | $378 | 211% |
| Custom Design Benefits | $399 | 223% |
| Blue Benefit Administrators Of Massachusetts | $655 | 366% |
| Blue Care Network | $655 | 366% |
| Blue Distinction Transplant | $655 | 366% |
| Blue Shield - Ca | $655 | 366% |
| Blue Shield - Id (Regence) | $655 | 366% |
| Blue Shield - Ny Highmark Northeastern | $655 | 366% |
| Blue Shield - Ny Highmark Western | $655 | 366% |
| Blue Shield - Pa (Highmark) | $655 | 366% |
| Blue Shield - Wa (Regence) | $655 | 366% |
| Geha | $878 | 490% |
| Healthscope | $878 | 490% |
| Student Insurance Cma | $878 | 490% |
| Plain Church Group | $1,052 | 587% |
| Notre Dame Athletic Association | $2,144 | 1196% |
| Wc Notre Dame | $2,144 | 1196% |
| Luminare Health (Detroit) | $2,222 - $2,339 | 1240% |
| Ameriben | $2,339 | 1305% |
| Asr Health Benefits | $2,534 | 1414% |
| Christian Brother Services | $2,534 | 1414% |
| Employee Benefit Management | $2,534 | 1414% |
| Medical Mutual | $2,534 | 1414% |
| Meritain | $2,534 | 1414% |
| Preferred One | $2,534 | 1414% |
| Rural Carrier Health Benefit Plan | $2,534 | 1414% |
| Webtpa | $2,534 | 1414% |
| Encore Health | $2,733 | 1525% |
| Indiana Criminal Justice Inst | $2,733 | 1525% |
| Western & Southern Financial Group | $2,733 | 1525% |
| Cigna | $2,807 | 1566% |
| Group Administrators | $2,807 | 1566% |
| Health Partners | $2,807 | 1566% |
| Mvp | $2,807 | 1566% |
| Prairie States | $2,807 | 1566% |
| Priority Health | $2,807 | 1566% |
| Professional Benefit Administrators | $2,807 | 1566% |
| Sagamore Health Network | $2,807 - $3,001 | 1566% |
| Sisco Benefits | $2,807 | 1566% |
| Unified Group Services | $2,807 | 1566% |
| Goshen Preferred Network | $3,001 - $3,352 | 1675% |
| Signature Care | $3,235 | 1805% |
| Allied National Global Care | $3,508 | 1958% |
| Asrm - Reliance Standard Life Insurance | $3,508 | 1958% |
| Avmed Health Plan | $3,508 | 1958% |
| Christian Care Ministry | $3,508 | 1958% |
| Dean Health | $3,508 | 1958% |
| Fallon Health | $3,508 | 1958% |
| Family Life Insurance Company | $3,508 | 1958% |
| Freedom Life Insurance Company | $3,508 | 1958% |
| Ghc Scw | $3,508 | 1958% |
| International Benefit Administrators | $3,508 | 1958% |
| Lifetime Benefit Solutions | $3,508 | 1958% |
| Manhattan Life | $3,508 | 1958% |
| Medi Share | $3,508 | 1958% |
| Multiplan | $3,508 | 1958% |
| Pai | $3,508 | 1958% |
| Pan-American Life | $3,508 | 1958% |
| Paramount Hmo | $3,508 | 1958% |
| Phcs | $3,508 | 1958% |
| Philadelphia American Life Insurance | $3,508 | 1958% |
| Trinity Health Share | $3,508 | 1958% |
| Bankers Life Casualty | $3,898 | 2175% |
| Bureau Of Disability | $3,898 | 2175% |
| Wc Align Network | $3,898 | 2175% |