CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Nmc Health

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $1,355
  • Cash Discount Price: $1,650
  • vs. Medicare Baseline: 7.56x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Nmc Health is $1,355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,650. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.56x the Medicare baseline. Located in 600 Medical Center Drive, Newton, KS.
Cash / Self-Pay
$1,650

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,355

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: $1,650 (921%)
Insurance Median: $1,355 (756%)
Cash: $1,650 (921% of Medicare)
Ins. Median: $1,355 (756% 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 756% of the Medicare baseline (a markup of 656%). 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
Bluestem Pace $169 94%
Leading Age $270 151%
Medicaid / KanCare $270 151%
Blue Cross Blue Shield $480 268%
Aetna $503 281%
Wppa $1,296 723%
Occunet $1,414 789%
Samaritan Ministries International $1,532 855%
Medincrease Health Plan $1,532 855%
Prime Health Services $1,768 987%
UnitedHealthcare $2,121 1184%
Cigna $2,239 1249%

Consumer Guidance & Cost Commentary

For this CT scan of the head at Nmc Health in Newton, KS, the cash price is $1,650, which is lower than the facility's gross charge of $2,357. While the facility's negotiated rates with insurance plans range from $169 to $2,239, these amounts are often higher than the cash price due to administrative costs and contract structures. For patients with high-deductible plans, paying the cash price of $1,650 upfront can be more cost-effective than relying on insurance, especially since some commercial rates exceed the cash amount. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket may result in immediate savings if your insurance has not yet covered the service.

When evaluating the cost against state and county benchmarks, the Medicare benchmark for this procedure is $179.20. Commercial negotiated rates typically average between 200% and 300% of this Medicare rate, whereas fair pricing is generally defined as 120% to 150%. The facility's cash price of $1,650 represents a significant markup over the Medicare rate, reflecting the complexity of the service and local wage indexes. To potentially reduce your bill further, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer an additional 20% to 50% reduction for upfront payment. Always request a detailed, itemized bill before paying to ensure there are no errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Medical Center Drive, Newton, KS 67114
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals