CT scan, head (with and without contrast)
Facility: Decatur Health
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $954
- Cash Discount Price: $1,125
- vs. Medicare Baseline: 5.32x 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 532% of the Medicare baseline (a markup of 432%). 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 | 329% |
| Wppa/Providrs Care- All Plans | $750 | 419% |
| UnitedHealthcare | $763 - $954 | 426% |
| Humana | $770 | 430% |
| Aetna | $1,125 - $1,250 | 628% |
| Midlands Choice- All Plans | $1,125 | 628% |
| Medicaid / KanCare | $1,263 | 705% |
Consumer Guidance & Cost Commentary
For the CPT code 70470 (CT scan, head with and without contrast) at Decatur Health in Oberlin, KS, the cash median price is $1,125, which is notably lower than the negotiated rates paid by most major insurers. While the facility's cash rate is close to the state average, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds the cash price. It is important to note that commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $763 to $1,250, which are significantly higher than the cash option. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative costs associated with insurance billing.
This procedure also serves as a benchmark for understanding pricing relative to federal standards. The Medicare amount for this service is $179.20, and the facility's cash rate of $1,125 represents a substantial markup compared to this federal baseline, illustrating how commercial rates often differ from the "true cost" of care. Because balance billing can occur when services are out-of-network, patients should verify their network status and request an itemized bill to ensure no unexpected charges are added after insurance processing. If a patient receives a summary bill that obscures individual line items, they should demand a full CPT-coded statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain such discrepancies.