CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Nemaha Valley Community Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70450
  • Insurance Median: $869
  • Cash Discount Price: $1,558
  • vs. Medicare Baseline: 8.14x Medicare
The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Nemaha Valley Community Hospital is $869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,558. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.14x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$1,558

Average discount available for prompt cash payment at this facility.

Insurance Median
$869

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,558 (1459%)
Insurance Median: $869 (814%)
Cash: $1,558 (1459% of Medicare)
Ins. Median: $869 (814% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 814% of the Medicare baseline (a markup of 714%). 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
Blue Cross Blue Shield $480 449%
Va Ccn - All Plans $762 713%
Humana $762 713%
Aetna $769 - $1,471 720%
Celtic Comm Exch - All Plans $838 785%
Partners Direct Health - All Plans $900 843%
Multiplan - All Plans $1,558 1459%
Midlands Choice - All Plans $1,644 1539%
Health Partners - All Plans $1,644 1539%

Consumer Guidance & Cost Commentary

For this CT scan of the head at Nemaha Valley Community Hospital in Seneca, Kansas, the cash price of $1,558 is notably higher than the facility's negotiated rate of $869 and the median paid amount of $900. While the gross charge listed is $1,731, the most significant benchmark for understanding the true cost of care here is the Medicare amount of $106.81. This indicates that the commercial rates charged to patients are significantly above the federal government's baseline reimbursement for this service.

Commercial insurance carriers such as Blue Cross Blue Shield and Humana have agreed to pay rates ranging from $480 to $900, which are still well above the Medicare benchmark but serve as the ceiling for in-network coverage. Patients should be aware that paying out-of-pocket for the cash price of $1,558 may not offer savings unless their specific insurance plan's negotiated rate exceeds this amount, which is uncommon given the data shows most negotiated rates are lower. To potentially reduce costs, patients should directly contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can lower the bill by bypassing administrative fees and insurance claim processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals