CT scan, head (with and without contrast)
Facility: Holton Community Hospital
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $1,249
- Cash Discount Price: $1,129
- vs. Medicare Baseline: 6.97x 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 697% of the Medicare baseline (a markup of 597%). 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 | $453 | 253% |
| UnitedHealthcare | $798 - $1,505 | 445% |
| Aetna | $798 - $1,505 | 445% |
| Humana | $806 | 450% |
| Kansas Superior Select - All Plans | $814 | 454% |
| Preferred Health Professionals | $1,249 | 697% |
| Preferred Health Freedom | $1,249 | 697% |
| Preferred Health Fn Select - All Other Plans | $1,249 | 697% |
| Wppa Providers - All Plans | $1,430 | 798% |
| Medicaid / KanCare | $1,505 | 840% |
Consumer Guidance & Cost Commentary
For the CPT code 70470, representing a CT scan of the head with and without contrast, Holton Community Hospital in Kansas has a gross charge of $1,505.00. While the facility's cash median price is $1,129.00, in-network insurance plans typically pay higher amounts due to negotiated rates; for instance, UnitedHealthcare and Aetna pay between $798 and $1,505, while Medicaid/KanCare pays the full gross amount of $1,505.00. This pricing structure highlights that cash-paying patients may achieve significant savings compared to insurance reimbursement, particularly if their plan's negotiated rate exceeds the cash price. It is important to note that the facility is a Critical Access Hospital in Holton, KS, and while specific county or state average data was not provided in the source material, patients should verify their specific plan's allowed amount before scheduling to ensure they are aware of their out-of-pocket costs.
Patients should be aware that paying cash upfront can sometimes be cheaper than using insurance, especially for those with high-deductible plans where the insurance negotiated rate might exceed the cash price. To maximize savings, individuals should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. Additionally, if a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the provider's full charge and the insurance payment. Under the No Surprises Act, balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities, so