CT scan, head (with contrast)
Facility: Kansas City Orthopaedic Institute
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- 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 |
|---|---|---|
| Aetna | $163 | 91% |
| UnitedHealthcare | $163 | 91% |
| Cigna | $167 | 93% |
| Blue Cross Blue Shield | $424 | 237% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $163 to $424 depending on the insurance carrier. While the median negotiated rate is $424, this figure is significantly higher than the Medicare benchmark of $179.20, reflecting the typical administrative markup associated with commercial contracts. Patients with high-deductible plans should consider that paying cash directly might be more cost-effective, as the cash price could be lower than the insurance negotiated rate, provided the patient's out-of-pocket costs do not exceed the savings. It is essential to verify the facility's specific "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can substantially reduce the final bill by bypassing the costly insurance claims process.
This service is categorized under Acute Care Hospitals, and while specific cash or median paid amounts are not available in the current dataset, the data highlights the importance of understanding balance billing risks. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they could face balance billing for the difference between the full chargemaster rate and the insurance allowed amount, though the No Surprises Act offers protections for emergency and non-emergency services at in-network facilities. To ensure accuracy, patients should request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as double-billing or unbundled codes. Disputing these errors in writing is the most effective way to reduce medical debt and prevent unexpected charges.