CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Woodlawn Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $627
Cash Discount Price: $2,138
vs. Medicare Baseline: 3.50x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Woodlawn Hospital is $627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,138. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.50x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$2,138

Average discount available for prompt cash payment at this facility.

Insurance Median

$627

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: $2,138 (1193%)

Insurance Median: $627 (350%)

Cash: $2,138 (1193% of Medicare)

Ins. Median: $627 (350% 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 350% of the Medicare baseline (a markup of 250%). 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	$97 - $2,166	54%
Caresource Mcaid Hww	$97	54%
Mdwise Excel Hhw & Hcc	$97	54%
Mhs Mcaid Hcc	$97	54%
Mhs Mcaid Hhw	$97	54%
UnitedHealthcare	$97 - $2,166	54%
Aetna	$627 - $2,708	350%
Caresource Mcaid Hip	$627	350%
Caresource Mcr Adv	$627	350%
Humana	$627 - $2,212	350%
Mdwise Mcaid Excel Hip	$627	350%
Mhs Exch Mrktplce-All Other Plans	$627	350%
Mhs Mcaid Hip	$627	350%
Mhs Mcr Adv	$640	357%
Caresource Exch - All Other Plans	$815	455%
Ambetter / Centene	$834	465%
Partners Direct Health-All Plans	$1,938	1081%
Cigna	$2,041 - $2,422	1139%
Parkview Health Plans-All Plans	$2,138	1193%
Sagamore All Other Grps - All Other Plans	$2,394	1336%
Encore Comm-All Plans	$2,422	1352%
Phcs/Multiplan-All Plans	$2,650	1479%
Community Health Alliance-All Plans	$2,708	1511%

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 $2,138.
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 Woodlawn 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.