CT scan, head (with contrast)
Facility: Wamego Health Center
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $119
- Cash Discount Price: $1,146
- vs. Medicare Baseline: 0.66x 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.
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 |
|---|---|---|
| UnitedHealthcare | $44 - $153 | 25% |
| Medicaid / KanCare | $46 - $171 | 26% |
| Aetna | $46 - $159 | 26% |
| Providrs Care | $72 - $204 | 40% |
| Tricare | $297 | 166% |
| Blue Cross Blue Shield | $631 - $664 | 352% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, the facility's cash median price is $1,146.00, which is significantly lower than the gross charge of $2,864.00. While commercial insurance plans like UnitedHealthcare and Aetna have negotiated rates ranging from $44 to $171, these amounts often exceed the cash price for patients with high-deductible plans who may not yet have met their out-of-pocket thresholds. In such cases, paying the cash rate directly can result in immediate savings compared to the administrative costs and potential deductibles associated with insurance billing. It is advisable to contact the facility directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost relative to Medicare, the facility's cash rate is 643% higher than the Medicare benchmark of $179.20, indicating a substantial markup typical of commercial pricing structures. Although the data does not provide specific state or county average comparisons for this procedure, the wide variance in negotiated rates among payers—ranging from a low of $44 with UnitedHealthcare to a high of $664 with Blue Cross Blue Shield—highlights the importance of verifying your specific plan's allowed amount before scheduling. Patients should request an itemized bill to ensure no errors exist and to confirm that the final charge aligns with the negotiated or cash rates discussed, avoiding unexpected balance billing where applicable.