CT scan, head (with contrast)
Facility: Nemaha Valley Community Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $923
- Cash Discount Price: $1,655
- vs. Medicare Baseline: 5.15x 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 515% of the Medicare baseline (a markup of 415%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $480 | 268% |
| Va Ccn - All Plans | $809 | 451% |
| Humana | $809 | 451% |
| Aetna | $817 - $1,563 | 456% |
| Celtic Comm Exch - All Plans | $890 | 497% |
| Partners Direct Health - All Plans | $956 | 533% |
| Multiplan - All Plans | $1,655 | 924% |
| Midlands Choice - All Plans | $1,747 | 975% |
| Health Partners - All Plans | $1,747 | 975% |
Consumer Guidance & Cost Commentary
For this CT scan of the head with contrast at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash price of $1,655 is notably higher than the state average, which sits at $956. While commercial insurance negotiated rates generally cap costs for in-network members, they often exceed cash prices due to administrative overhead and contract structures. In this case, the median negotiated rate across payers is $956, which aligns closely with the state average, but patients with high-deductible plans should verify if paying cash upfront could result in lower out-of-pocket costs, especially if their insurance allows for balance billing or if the specific payer's allowed amount exceeds the cash rate.
To ensure you receive the most accurate pricing, it is essential to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, while the Medicare benchmark for this service is $179.20, commercial rates are frequently marked up significantly above this federal baseline; however, the facility's cash price remains well above the Medicare amount, suggesting that for many patients, the negotiated rate of $923 or the cash price of $1,655 will be the primary financial consideration. Always request an itemized bill to review specific CPT codes and avoid unexpected charges, and remember that the No Surprises Act protects you from balance billing for emergency care or non-emergency services at in-network facilities.