CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Nmc Health

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $910
  • Cash Discount Price: $1,107
  • vs. Medicare Baseline: 5.08x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Nmc Health is $910. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,107. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.08x the Medicare baseline. Located in 600 Medical Center Drive, Newton, KS.
Cash / Self-Pay
$1,107

Average discount available for prompt cash payment at this facility.

Insurance Median
$910

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: $1,107 (618%)
Insurance Median: $910 (508%)
Cash: $1,107 (618% of Medicare)
Ins. Median: $910 (508% 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 508% of the Medicare baseline (a markup of 408%). 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%
Medicaid / KanCare $270 151%
Leading Age $270 151%
Aetna $408 228%
Blue Cross Blue Shield $480 268%
Wppa $870 485%
Occunet $949 530%
Medincrease Health Plan $1,028 574%
Samaritan Ministries International $1,028 574%
Prime Health Services $1,186 662%
UnitedHealthcare $1,423 794%
Cigna $1,502 838%

Consumer Guidance & Cost Commentary

For this CT scan of the head with contrast at Nmc Health in Newton, Kansas, the facility's cash price of $1,107 is lower than the state average, which sits at $1,502. While commercial insurance plans like UnitedHealthcare and Cigna negotiate rates of $1,423 and $1,502 respectively, these amounts exceed the cash price. If you have a high-deductible plan or have not yet met your deductible, paying the cash price directly may result in significant savings compared to the insurance negotiated rate. Patients should explicitly ask the hospital about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can further reduce the final cost by bypassing administrative fees associated with insurance billing.

It is important to understand that commercial negotiated rates often include administrative overhead and do not represent the true cost of care, which is better reflected by the Medicare benchmark of $179.20. Comparing the facility's rates to this federal baseline reveals a substantial markup, highlighting that commercial prices are significantly higher than the government's cost-based standard. If you receive a bill that includes charges for out-of-network services, such as specific lab tests or ancillary procedures, you may be subject to balance billing for the difference between the allowed amount and the full charge. In such cases, you should request an itemized billing audit to identify errors, unbundled codes, or services not rendered, and formally dispute any balance bills using the No Surprises Act protections rather than accepting summary bills or signing away your rights.

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