CT scan, head (no contrast)
Facility: Decatur Health
Billing Code: 70450 (CPT)
- CPT Billing Code: 70450
- Insurance Median: $852
- Cash Discount Price: $1,005
- vs. Medicare Baseline: 7.98x 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 $106.81 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 798% of the Medicare baseline (a markup of 698%). 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 | $589 | 551% |
| Wppa/Providrs Care- All Plans | $670 | 627% |
| UnitedHealthcare | $681 - $852 | 638% |
| Humana | $688 | 644% |
| Aetna | $1,005 - $1,116 | 941% |
| Midlands Choice- All Plans | $1,005 | 941% |
| Medicaid / KanCare | $1,128 | 1056% |
Consumer Guidance & Cost Commentary
For this CT scan of the head (no contrast) at Decatur Health in Oberlin, Kansas, the facility's cash median rate is $1,005, which aligns closely with the cash median for the state of Kansas. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary significantly by insurer. For example, UnitedHealthcare has a negotiated range of $681 to $852, whereas Aetna's range is $1,005 to $1,116. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics; therefore, patients with high-deductible plans may find paying the cash price of $1,005 more cost-effective than relying on insurance, especially if their deductible has not yet been met.
When evaluating the financial impact of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare amount for this procedure is $106.81, and the facility's cash rate represents an 8.0% markup relative to this federal baseline, which falls well within the range of fair pricing (typically 120% to 150% of Medicare). Additionally, the median negotiated rate across payers is $852, which is lower than the cash price, suggesting that for some insurance plans, the allowed amount may be favorable. Patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost by bypassing insurance billing cycles and administrative fees.