CT scan, head (with and without contrast)
Facility: Ellsworth County Medical Center
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $855
- Cash Discount Price: $950
- vs. Medicare Baseline: 4.77x 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 477% of the Medicare baseline (a markup of 377%). 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 | $430 - $453 | 240% |
| Healthy Blue Mcr Adv | $446 | 249% |
| Va Ccn-All Plans | $446 | 249% |
| Triwest -All Plans | $446 | 249% |
| Humana | $446 - $902 | 249% |
| UnitedHealthcare | $618 - $950 | 345% |
| Aetna | $855 | 477% |
| First Health - All Plans | $855 | 477% |
| Cigna | $902 | 503% |
| Coventry Mcaid-All Plans | $950 | 530% |
| Healthy Blue Mcaid- All Other Plans | $950 | 530% |
| Medicaid / KanCare | $950 | 530% |
| Providers Care-Wppa-All Plans | $1,425 | 795% |
Consumer Guidance & Cost Commentary
For a CT scan of the head at Ellsworth County Medical Center, the facility's cash price is $950, which matches the gross chargemaster rate. This amount is significantly higher than the state average for this procedure, as indicated by the 4.8x difference against the Medicare benchmark of $179.20. While commercial insurance plans like Humana and UnitedHealthcare have negotiated rates ranging from $618 to $950, patients with high-deductible plans might find paying the full cash price of $950 more cost-effective than relying on insurance, especially if their out-of-pocket maximum is not yet met. It is crucial to verify your specific plan's deductible status before scheduling, as some in-network rates can exceed the cash price due to administrative overhead and contract dynamics.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur from out-of-network ancillary services like certain lab tests or physician visits. If you receive a bill that seems unusually high, request a formal itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle that insurance companies utilize. Always ensure you are not signing away your rights to dispute out-of-network charges before agreeing to any consent waivers.