CT scan, head (with and without contrast)
Facility: Phillips County Hospital
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $572
- Cash Discount Price: $537
- vs. Medicare Baseline: 3.19x 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 319% of the Medicare baseline (a markup of 219%). 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 | $480 - $512 | 268% |
| UnitedHealthcare | $506 - $632 | 282% |
| Health Partners-All Plans | $632 | 353% |
| Medicaid / KanCare | $632 | 353% |
Consumer Guidance & Cost Commentary
For a CT scan of the head at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash median rate is $537.00, which is lower than the negotiated rates paid by major insurers like UnitedHealthcare ($512.00 to $632.00) and Blue Cross Blue Shield ($480.00 to $512.00). This price difference highlights a common billing dynamic where paying out-of-pocket can sometimes be more economical than using insurance, particularly for patients with high deductibles who may face higher out-of-pocket costs after their plan's allowed amount is applied. While the facility is a Critical Access Hospital with government local ownership, patients should verify their specific plan details and ask directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill.
When reviewing your statement, it is crucial to request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Additionally, while the facility's gross charge is $632.00, the Medicare benchmark rate for this procedure is $179.20, providing a clear baseline to evaluate the facility's pricing markup against federal standards. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act generally protects you from paying the difference between the provider's full rate and your insurance allowed amount for emergency care and non-emergency services at in-network facilities, so you should dispute any unexpected charges with your insurer rather than paying immediately.