CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Graham County Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $488
  • Cash Discount Price: $630
  • vs. Medicare Baseline: 2.72x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Graham County Hospital is $488. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $630. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.72x the Medicare baseline. Located in 304 West Prout Street, Hill City, KS.
Cash / Self-Pay
$630

Average discount available for prompt cash payment at this facility.

Insurance Median
$488

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: $630 (352%)
Insurance Median: $488 (272%)
Cash: $630 (352% of Medicare)
Ins. Median: $488 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Medicaid / KanCare $245 137%
UnitedHealthcare $245 - $598 137%
Blue Cross Blue Shield $453 253%
Medicare (plans) $472 263%
Celtic Commercial-All Other Plans $520 290%
Wppa (Providers Care)-All Plans $598 334%

Consumer Guidance & Cost Commentary

For a CT scan of the head at Graham County Hospital in Hill City, Kansas, the cash price is $630.00, which matches the facility's median negotiated rate. This cash price is notably lower than the state average for this procedure, where the median paid amount is $520.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying out-of-pocket initially cheaper than using insurance, as the cash rate avoids the administrative overhead and potential balance billing associated with commercial claims. It is important to note that while the facility offers a cash price, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final cost by bypassing the standard insurance billing cycle.

The facility's pricing structure is anchored by a Medicare rate of $179.20, which serves as the objective baseline for evaluating commercial markups. Commercial payers negotiate rates that typically range from $245 to $598, with UnitedHealthcare showing the widest variation across its three plans. Because the cash price of $630.00 exceeds the Medicare benchmark, patients should be aware that commercial rates often include significant administrative costs and contractual adjustments that do not reflect the true cost of care. To ensure transparency, consumers should request an itemized bill to review specific CPT codes and avoid summary bills that obscure individual charges, and they should dispute any balance billing immediately if it occurs, as federal protections like the No Surprises Act may apply depending on the specific services rendered.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 304 West Prout Street, Hill City, KS 67642
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals