CT scan, head (with and without contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $601
- Cash Discount Price: $633
- vs. Medicare Baseline: 3.35x 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 335% of the Medicare baseline (a markup of 235%). 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 |
|---|---|---|
| Tricare | $507 | 283% |
| Humana | $576 | 321% |
| Aetna | $585 - $633 | 326% |
| Hpk-All Plans | $601 | 335% |
| UnitedHealthcare | $601 | 335% |
| Medicaid / KanCare | $633 | 353% |
Consumer Guidance & Cost Commentary
For the CT scan of the head (with and without contrast) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $633.00, which matches the facility's gross charge and the median amount paid by commercial payers. This rate is 3.4 times higher than the Medicare benchmark of $179.20, indicating a significant markup relative to the federal government's cost-based reimbursement. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should note that cash payments may sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price, particularly for those with high-deductible plans.
The facility's negotiated rates range from $507 to $633 across six payers, with Tricare and Humana paying the lowest amounts at $507 and $576 respectively. Although the data does not provide specific state or county average comparisons for this procedure, the wide variation in negotiated rates among payers highlights the importance of verifying allowed amounts before scheduling. Patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, because the facility is in-network, the No Surprises Act protects patients from balance billing for out-of-network services, but patients should still request an itemized bill to ensure no unbundled codes or services not rendered are included.