CT scan, head (with contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- 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% |
| UnitedHealthcare | $601 | 335% |
| Hpk-All Plans | $601 | 335% |
| Medicaid / KanCare | $633 | 353% |
Consumer Guidance & Cost Commentary
For a CT scan of the head with contrast at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $633.00, which matches the facility's gross charge and the median amount paid by Medicaid/KanCare. While commercial insurers like Aetna and UnitedHealthcare negotiate rates ranging from $576 to $633, these amounts are significantly higher than the cash price. This pricing structure highlights the potential benefit of paying out-of-pocket, as the cash rate is lower than the negotiated rates for most commercial payers, which can be advantageous for patients with high deductibles or those without insurance.
The facility's pricing is benchmarked against the Medicare rate of $179.20, showing a markup of 3.4 times the federal baseline, which aligns with typical commercial pricing dynamics where negotiated rates often exceed 200% of Medicare. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still crucial to request a prompt-pay discount or self-pay rate before scheduling. To ensure you are not overcharged, always ask the hospital to classify your account as self-pay prior to check-in and request a full itemized bill to verify that no unbundled codes or services not rendered have been included in your final statement.