CT scan, head (with and without contrast)
Facility: Kansas City Orthopaedic Institute
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $424
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.37x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 237% of the Medicare baseline (a markup of 137%). 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.
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 | $163 | 91% |
| Aetna | $163 | 91% |
| Cigna | $167 | 93% |
| Blue Cross Blue Shield | $424 | 237% |
Consumer Guidance & Cost Commentary
For the CPT code 70470, representing a CT scan of the head with and without contrast, the Kansas City Orthopaedic Institute in Leawood, KS, has a median negotiated rate of $424.00. This rate is significantly higher than the state average, which is $179.20 (the Medicare benchmark). While commercial payers like UnitedHealthcare, Aetna, and Cigna have a fixed allowed amount of $163 to $167, Blue Cross Blue Shield pays $424 across five plans. Because the negotiated rate exceeds the Medicare benchmark, patients with high-deductible plans might find that paying the cash price directly could result in lower out-of-pocket costs if the facility offers a self-pay or prompt-pay discount. It is important to verify these discounts with the hospital before scheduling, as they can bypass the administrative costs associated with insurance billing.
Patients should be aware that commercial negotiated rates often include administrative overhead, which can inflate the price compared to the federal Medicare baseline. In this case, the facility's negotiated rate is more than double the Medicare amount, highlighting the markup typical in commercial contracts. If you receive a bill that appears to include balance billing for out-of-network services, you have protections under the No Surprises Act, which bans such charges for emergency and non-emergency care at in-network facilities. Furthermore, if you are presented with a summary bill, you have the right to request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through a formal written dispute.