CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Lmh

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $177
  • Cash Discount Price: $871
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Lmh is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $871. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.99x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$871

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $871 (486%)
Insurance Median: $177 (99%)
Cash: $871 (486% of Medicare)
Ins. Median: $177 (99% 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.

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
Medicare (plans) $66 - $177 37%
Humana $66 - $177 37%
Cigna $66 - $2,327 37%
UnitedHealthcare $66 - $2,313 37%
Haskell Indian Health Services $77 - $177 43%
Blue Cross Blue Shield $77 - $2,254 43%
Allwell $79 - $180 44%
Ambetter / Centene $79 - $274 44%
Aetna $1,835 - $2,891 1024%
Non Contracted $2,786 1555%
First Health $3,239 1807%

Consumer Guidance & Cost Commentary

For this CT scan of the head (with and without contrast) at Lmh in Lawrence, KS, the facility's cash median price is $871.00, which is significantly lower than the state average for this procedure. While the facility is a government-owned acute care hospital, patients should be aware that commercial insurance negotiated rates can sometimes exceed the cash price due to administrative overhead and contract structures. For instance, Cigna and UnitedHealthcare have negotiated ranges extending up to $2,327 and $2,313 respectively, which are substantially higher than the cash rate. This dynamic suggests that patients with high-deductible plans might save money by paying the cash price directly, provided they have the funds available, as the insurance negotiated rate often includes multi-layered administrative costs that inflate the baseline price.

To ensure you are receiving the most accurate and fair pricing, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the facility offers a prompt-pay discount for upfront payment, you should contact the billing department to confirm if a self-pay or prompt-pay rate is available before scheduling your visit. This proactive step can help bypass the costly insurance claims cycle, which typically adds 20% to 40% in administrative fees, and ensure you are not inadvertently agreeing to a higher negotiated rate that exceeds the cash option. Always verify your deductible status and ask for a written confirmation of any discounts to avoid unexpected balance billing or verbal disputes that lack written records.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals