CT scan, head (with contrast)
Facility: Clara Barton Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $1,407
- Cash Discount Price: $1,094
- vs. Medicare Baseline: 7.85x 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 785% of the Medicare baseline (a markup of 685%). 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% |
| 6 Degrees Health - All Plans | $1,094 | 610% |
| Wppa-All Plans | $1,250 | 698% |
| Phcs - All Plans | $1,407 | 785% |
| Aetna | $1,407 | 785% |
| UnitedHealthcare | $1,407 | 785% |
| Hlth Partners Of Ks-All Plans | $1,438 | 802% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, Clara Barton Hospital in Hoisington, KS, lists a cash median price of $1,094.00 and a median negotiated rate of $1,407.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates for major payers like Blue Cross Blue Shield and 6 Degrees Health are fixed at $453.00 and $1,094.00 respectively, which aligns with the cash price. However, other insurers such as Wppa-All Plans and Phcs - All Plans have negotiated rates of $1,250.00 and $1,407.00, which exceed the cash median. Patients with high-deductible plans may find the cash price of $1,094.00 more affordable than their insurance allowed amounts, provided they can secure a self-pay or prompt-pay discount before the claim is submitted. It is important to verify these rates directly with the hospital, as commercial negotiated rates often include administrative overhead that can inflate the baseline price compared to the true cost of care.
The facility's Medicare amount for this procedure is $179.20, which serves as the objective baseline for evaluating pricing markups. The reported versus Medicare variance of 7.9% indicates that the facility's pricing is significantly lower than the typical commercial markup range of 200% to 300% often seen in the industry, suggesting a competitive pricing model relative to federal standards. Although the data does not provide specific county or state average