CT scan, head (with contrast)
Facility: Greenwood County Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $1,101
- Cash Discount Price: $1,042
- vs. Medicare Baseline: 6.14x 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 614% of the Medicare baseline (a markup of 514%). 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 | $430 - $453 | 240% |
| Triwest - All Plans | $465 | 259% |
| Choicecare Mcr Adv - All Plans | $547 | 305% |
| UnitedHealthcare | $547 - $1,095 | 305% |
| Tricare | $547 | 305% |
| Integrated Health Plan - All Plans | $977 | 545% |
| First Health - All Other Plans | $1,108 | 618% |
| First Health Ccn Network | $1,108 | 618% |
| Beech Street - All Plans | $1,108 | 618% |
| Preferred Hs (Coventry) - All Plans | $1,173 | 655% |
| Principal Health Care Inc - All Plans | $1,238 | 691% |
| Medicaid / KanCare | $1,303 | 727% |
| Amerigroup Mcaid-All Plans | $1,303 | 727% |
| Providrs Care/Wppa - All Plans | $1,954 | 1090% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, Greenwood County Hospital in Eureka, Kansas, lists a gross charge of $1,303.00. While the facility's cash median rate is $1,042.00 and the median negotiated rate for in-network payers is $1,101.00, these figures are significantly higher than the Medicare benchmark of $179.20. Under federal Medicare benchmarking standards, commercial rates typically range from 200% to 300% of the Medicare rate, whereas fair pricing is generally defined as 120% to 150%. This specific code shows a negotiated rate that exceeds the 150% fair pricing threshold, indicating a substantial markup relative to the federal cost baseline.
Patients should be aware that insurance negotiated rates often include administrative overhead and contract ceilings that can make them higher than cash prices, particularly for those with high-deductible plans. For this service, the cash price of $1,042.00 is lower than the median negotiated amount of $1,101.00, suggesting that paying out-of-pocket might result in lower out-of-pocket costs if the patient's insurance deductible has not yet been met. To secure the best possible rate, patients are encouraged to ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. Additionally, since this is a Critical Access Hospital, the No Surprises Act provides federal protection against balance billing for out-of-network services, ensuring that