CT scan, head (with contrast)
Facility: Wilson Medical Center
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $701
- Cash Discount Price: $657
- vs. Medicare Baseline: 3.91x 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 391% of the Medicare baseline (a markup of 291%). 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 | $453 - $876 | 253% |
| UnitedHealthcare | $464 - $815 | 259% |
| Aetna | $464 - $876 | 259% |
| Ambetter / Centene | $464 - $876 | 259% |
| Humana | $464 | 259% |
| Tricare | $464 | 259% |
| Cigna | $701 | 391% |
| Health Partners-All Plans | $806 | 450% |
| Mulitplan-All Plans | $806 | 450% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, Wilson Medical Center in Neodesha, KS, lists a gross charge of $876.00. While the facility's cash median price is $657.00, which is lower than the gross charge, it is important to note that this rate may not be the lowest possible option for patients with high-deductible plans. Commercial insurance carriers negotiate rates that often exceed cash prices due to administrative overhead and contract dynamics; for instance, the median negotiated rate across payers is $701.00, and individual payer ranges span from $453 to $876. Patients should verify their specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the best price can lead to higher out-of-pocket costs if the insurer's ceiling is above the cash rate. Additionally, since this is a Critical Access Hospital, patients should proactively inquire about "self-pay" or "prompt-pay" discounts, which can bypass costly insurance billing cycles and reduce the final bill by 20% to 50% if paid upfront.
The facility's pricing can be contextualized against federal benchmarks to understand its markup. The Medicare amount for this procedure is $179.20, and the facility's cash median of $657.00 represents a significant markup relative to this federal baseline. While the data does not provide specific county or state average comparisons for this exact code, the facility's ownership is Government-Local, which often influences pricing structures. To ensure you are receiving fair value, it is recommended to request a full itemized billing audit rather than accepting