CT scan, head (with and without contrast)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $855
- Cash Discount Price: $760
- vs. Medicare Baseline: 4.77x 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 477% of the Medicare baseline (a markup of 377%). 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% |
| UnitedHealthcare | $855 - $950 | 477% |
| Providers Care (Wppa)-All Plans | $1,662 | 927% |
Consumer Guidance & Cost Commentary
For the CPT code 70470, representing a CT scan of the head with and without contrast, the facility's negotiated rate of $855.00 is significantly higher than the cash price of $760.00, reflecting the administrative costs and contract structures typical of commercial insurance. While the facility is a Critical Access Hospital in Anthony, KS, the data indicates a median paid amount of $855.00, which aligns with the negotiated rate provided by UnitedHealthcare. It is important to note that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $760.00 upfront could result in substantial savings compared to the insurance negotiated rate, as the commercial billing process often includes layers of administrative overhead that inflate the final cost.
When evaluating the value of this service, it is essential to compare the facility's pricing against the federal baseline rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $179.20, and the facility's negotiated rate is 4.8 times higher than this benchmark, which is consistent with the typical 200% to 300% markup seen in commercial healthcare pricing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, they must still verify their specific plan details before scheduling. To minimize costs, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment, effectively bypassing the higher administrative costs