CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Woodlawn Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $532
Cash Discount Price: $1,813
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Woodlawn Hospital is $532. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,813. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.97x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$1,813

Average discount available for prompt cash payment at this facility.

Insurance Median

$532

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: $1,813 (1012%)

Insurance Median: $532 (297%)

Cash: $1,813 (1012% of Medicare)

Ins. Median: $532 (297% 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 297% of the Medicare baseline (a markup of 197%). 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	$78 - $1,837	44%
Caresource Mcaid Hww	$78	44%
Mdwise Excel Hhw & Hcc	$78	44%
Mhs Mcaid Hcc	$78	44%
Mhs Mcaid Hhw	$78	44%
UnitedHealthcare	$78 - $1,837	44%
Aetna	$532 - $2,296	297%
Caresource Mcaid Hip	$532	297%
Caresource Mcr Adv	$532	297%
Humana	$532 - $1,876	297%
Mdwise Mcaid Excel Hip	$532	297%
Mhs Exch Mrktplce-All Other Plans	$532	297%
Mhs Mcaid Hip	$532	297%
Mhs Mcr Adv	$542	302%
Caresource Exch - All Other Plans	$691	386%
Ambetter / Centene	$707	395%
Partners Direct Health-All Plans	$1,644	917%
Cigna	$1,731 - $2,054	966%
Parkview Health Plans-All Plans	$1,813	1012%
Sagamore All Other Grps - All Other Plans	$2,030	1133%
Encore Comm-All Plans	$2,054	1146%
Phcs/Multiplan-All Plans	$2,248	1254%
Community Health Alliance-All Plans	$2,296	1281%

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 $1,813.
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 Woodlawn 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.