CT scan, head (with and without contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $657
- Cash Discount Price: $714
- vs. Medicare Baseline: 3.67x 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 367% of the Medicare baseline (a markup of 267%). 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 |
|---|---|---|
| Humana | $412 | 230% |
| Tricare | $444 | 248% |
| Medicaid / KanCare | $521 - $840 | 291% |
| Aetna | $521 - $756 | 291% |
| Va Ccn - All Plans | $521 | 291% |
| UnitedHealthcare | $521 - $840 | 291% |
| Ambetter / Centene | $573 | 320% |
| Blue Cross Blue Shield | $657 | 367% |
| Health Partners - All Plans | $798 | 445% |
| Healthy Blue Mcaid - All Plans | $840 | 469% |
Consumer Guidance & Cost Commentary
For the CPT code 70470, representing a CT scan of the head with and without contrast, the facility's cash median price is $714.00, which is lower than the gross charge of $840.00. While the facility is a Critical Access Hospital in Wakeeney, KS, the data provided does not include specific county or state average figures for comparison. However, the cash price of $714.00 is notably higher than the Medicare benchmark of $179.20, reflecting the typical administrative markup inherent in commercial billing structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the facility's negotiated rates range from $412 to $840 depending on the payer, and some commercial payers like UnitedHealthcare and Medicaid/KanCare have negotiated rates that exceed the cash price.
The facility offers a median negotiated rate of $521.00, which aligns with the lowest end of the range for several major payers including Tricare, Va Ccn, and Ambetter/Centene. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, patients should still verify their network status and request a prompt-pay discount if they choose to pay out-of-pocket. To ensure accuracy, consumers should request a full itemized bill before paying, as summary bills can obscure unbundled charges or services not rendered. Given that the facility is government-owned locally, patients are encouraged to contact the billing department directly to confirm self-pay rates and any available prompt-pay incentives prior to scheduling the procedure.