CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Ellinwood District Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $490
  • Cash Discount Price: $595
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Ellinwood District Hospital is $490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.73x the Medicare baseline. Located in 605 N Main Street, Ellinwood, KS.
Cash / Self-Pay
$595

Average discount available for prompt cash payment at this facility.

Insurance Median
$490

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: $595 (332%)
Insurance Median: $490 (273%)
Cash: $595 (332% of Medicare)
Ins. Median: $490 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Cigna $490 273%
UnitedHealthcare $490 273%
Aetna $490 273%
Blue Cross Blue Shield $490 273%
Humana $490 273%

Consumer Guidance & Cost Commentary

For the CPT code 70470 (CT scan, head with and without contrast), Ellinwood District Hospital in Kansas has a gross charge of $700.00, which is significantly higher than the state average. However, the facility's negotiated rate of $490.00 aligns perfectly with the state average, while the cash price of $595.00 is lower than the negotiated amount. This pricing structure suggests that for patients with high-deductible plans, paying the cash price of $595.00 upfront could result in lower out-of-pocket costs compared to the $490.00 allowed amount paid by insurance carriers like Cigna, UnitedHealthcare, and Aetna. Since the cash price is already below the negotiated rate, there is no financial benefit to waiting for insurance to process the claim, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling.

The facility's pricing reflects a standard markup over the Medicare benchmark of $179.20, with the negotiated rate representing approximately 273% of the Medicare amount. While commercial rates often average between 200% and 300% of Medicare, this specific code shows a negotiated rate that is 2.7 times the Medicare amount, consistent with typical industry markups. To ensure you are receiving the most accurate billing information, it is recommended to request an itemized bill that lists specific CPT codes rather than accepting a summary invoice, as this helps identify any unbundled charges or services not rendered. Additionally, if you encounter a balance bill for out-of-network ancillary services, remember that the

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 N Main Street, Ellinwood, KS 67526
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals