CT scan, head (with contrast)
Facility: Ellsworth County Medical Center
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $743
- Cash Discount Price: $825
- vs. Medicare Baseline: 4.15x 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 415% of the Medicare baseline (a markup of 315%). 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 |
|---|---|---|
| Va Ccn-All Plans | $388 | 217% |
| Humana | $388 - $784 | 217% |
| Triwest -All Plans | $388 | 217% |
| Healthy Blue Mcr Adv | $388 | 217% |
| Blue Cross Blue Shield | $430 - $453 | 240% |
| UnitedHealthcare | $536 - $825 | 299% |
| First Health - All Plans | $742 | 414% |
| Aetna | $742 | 414% |
| Cigna | $784 | 438% |
| Healthy Blue Mcaid- All Other Plans | $825 | 460% |
| Medicaid / KanCare | $825 | 460% |
| Coventry Mcaid-All Plans | $825 | 460% |
| Providers Care-Wppa-All Plans | $1,238 | 691% |
Consumer Guidance & Cost Commentary
For a CT scan of the head with contrast at Ellsworth County Medical Center, the cash price is $825, which matches the facility's negotiated rate for Medicaid and several other payers. While the facility's cash price is higher than the state average for this service, it is important to note that for patients with high-deductible plans, paying cash upfront can sometimes be more cost-effective than relying on insurance, as commercial negotiated rates often exceed the cash price due to administrative overhead. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly claims processing and collection fees.
The facility's Medicare benchmark rate is $179.20, which serves as the objective baseline for evaluating pricing fairness. Although the cash price of $825 is significantly higher than the Medicare amount, this markup is common in the commercial market where rates average 200% to 300% of Medicare due to network tiering and administrative costs. If you have insurance, the allowed amount varies by carrier, ranging from $388 for some plans to $1,238 for Providers Care-Wppa-All Plans, but patients should verify their specific deductible status and ensure they are not signing away rights to dispute balance billing. Always request a detailed, itemized bill before paying to identify any errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit.