CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Lmh

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $177
  • Cash Discount Price: $770
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Lmh is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $770. 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
$770

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: $770 (430%)
Insurance Median: $177 (99%)
Cash: $770 (430% 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
UnitedHealthcare $66 - $2,045 37%
Medicare (plans) $66 - $177 37%
Humana $66 - $177 37%
Cigna $66 - $2,057 37%
Blue Cross Blue Shield $77 - $1,992 43%
Haskell Indian Health Services $77 - $177 43%
Allwell $79 - $180 44%
Ambetter / Centene $79 - $274 44%
Aetna $1,835 - $2,556 1024%
Non Contracted $2,464 1375%
First Health $2,864 1598%

Consumer Guidance & Cost Commentary

For CPT code 70460, a CT scan of the head with contrast, the facility's cash median price is $770.00, which is significantly lower than the gross chargemaster rate of $3,080.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Cigna range from $66 to over $2,000, the cash price often represents a more affordable option for patients with high-deductible plans or those without insurance. It is important to note that the facility's cash rate is notably higher than the state of Kansas average for this procedure, though specific county averages were not provided in the data. Patients should verify if their insurance plan has a deductible that exceeds the cash price before scheduling, as paying out-of-pocket may result in lower overall costs. Additionally, many facilities offer prompt-pay discounts for upfront payment, which can further reduce the final bill.

The Medicare benchmark for this service is $179.20, serving as a baseline to evaluate the facility's pricing markup. The facility's negotiated rates average $177.00, which is slightly below the Medicare amount, indicating a competitive pricing structure compared to the federal standard. However, the gross charges can be inflated, making it essential to compare rates against the Medicare benchmark rather than the full list price. If a patient receives care from an out-of-network provider at this facility, they may face balance billing for the difference between the allowed amount and the full charge, though the No Surprises Act protects against surprise bills for emergency services and non-emergency services from out-of-network providers at in-network facilities. To avoid unexpected costs, patients should request

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