CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Nemaha Valley Community Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $984
  • Cash Discount Price: $1,764
  • vs. Medicare Baseline: 5.49x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Nemaha Valley Community Hospital is $984. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,764. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.49x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$1,764

Average discount available for prompt cash payment at this facility.

Insurance Median
$984

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: $1,764 (984%)
Insurance Median: $984 (549%)
Cash: $1,764 (984% of Medicare)
Ins. Median: $984 (549% 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 549% of the Medicare baseline (a markup of 449%). 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 $480 268%
Humana $862 481%
Va Ccn - All Plans $862 481%
Aetna $871 - $1,666 486%
Celtic Comm Exch - All Plans $949 530%
Partners Direct Health - All Plans $1,019 569%
Multiplan - All Plans $1,764 984%
Health Partners - All Plans $1,862 1039%
Midlands Choice - All Plans $1,862 1039%

Consumer Guidance & Cost Commentary

For a CT scan of the head at Nemaha Valley Community Hospital in Seneca, KS, the cash median price is $1,764, which is 5.5% higher than the Medicare benchmark of $179.20. While this facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary significantly by insurer, ranging from $480 for Blue Cross Blue Shield to $1,862 for Health Partners and Midlands Choice. Because commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than relying on insurance, especially if the insurer's allowed amount exceeds the cash rate. It is important to verify your specific plan's negotiated rate before scheduling, as in-network status does not guarantee the lowest possible price.

To ensure you are not overcharged, request a full itemized CPT-coded bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days, effectively bypassing the costly claims processing cycle. Additionally, be aware that while the No Surprises Act protects you from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, you should still review your statement carefully to identify any unbundled codes or services not rendered. Always dispute any discrepancies in writing to the billing supervisor rather than accepting verbal assurances, ensuring you have a clear record of the final amount owed.

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