CT scan, head (with contrast)
Facility: Hiawatha Community Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $1,782
- Cash Discount Price: $2,288
- vs. Medicare Baseline: 9.94x 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 994% of the Medicare baseline (a markup of 894%). 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 | $456 - $480 | 254% |
| Aetna | $847 - $1,849 | 473% |
| UnitedHealthcare | $847 - $1,965 | 473% |
| Humana | $855 | 477% |
| Ambetter / Centene | $1,016 | 567% |
| Oscar - All Plans | $1,716 | 958% |
| Centrus Health Direct - All Plans | $1,716 | 958% |
| Preferred Hlth - All Plans | $2,059 | 1149% |
| Cigna | $2,174 | 1213% |
| Wppa Providrs Care - All Plans | $2,174 | 1213% |
| Midlands Choice - All Plans | $2,219 | 1238% |
| Multiplan - All Plans | $2,219 | 1238% |
| Healthy Blue Mcaid - All Plans | $2,288 | 1277% |
Consumer Guidance & Cost Commentary
For a CT scan of the head with contrast at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $2,288.00, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital owned by a voluntary non-profit, the negotiated rates vary significantly by insurer, ranging from $456 for Blue Cross Blue Shield plans to $2,288 for Healthy Blue Medicaid. Notably, the median negotiated rate across all payers is $1,849.00, which is lower than the cash price, suggesting that using insurance may result in a lower out-of-pocket cost for patients with active coverage. However, patients with high-deductible plans should verify their deductible status before scheduling, as paying the full cash price upfront could be more cost-effective if the insurance allowed amount exceeds the cash rate. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.
The facility's pricing is evaluated against federal benchmarks, with the Medicare amount for this service set at $179.20. The cash price of $2,288.00 represents a significant markup relative to the Medicare rate, illustrating how commercial rates can differ substantially from the government's cost-based baseline. While the data provided does not include specific state or county average comparisons for this procedure, the wide variance in negotiated rates among the 13 payers listed highlights the importance of checking your specific plan's allowed amount before receiving care.