CT scan, head (with contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $657
- Cash Discount Price: $684
- 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 | $394 | 220% |
| Tricare | $426 | 238% |
| Aetna | $499 - $724 | 278% |
| Va Ccn - All Plans | $499 | 278% |
| UnitedHealthcare | $499 - $805 | 278% |
| Medicaid / KanCare | $499 - $805 | 278% |
| Ambetter / Centene | $549 | 306% |
| Blue Cross Blue Shield | $657 | 367% |
| Health Partners - All Plans | $765 | 427% |
| Healthy Blue Mcaid - All Plans | $805 | 449% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, Trego County Lemke Memorial Hospital in Wakeeney, KS, has a gross charge of $805.00. While the facility's cash median price is $684.00, the negotiated rates paid by insurance plans range from $394.00 to $805.00, with a median negotiated amount of $657.00. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price. Additionally, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce the final bill by bypassing administrative processing costs.
When evaluating the value of this service, it is critical to compare rates against the Medicare benchmark rather than the hospital's full list price. The Medicare amount for this procedure is $179.20, which serves as the objective baseline for fair pricing. Commercial negotiated rates often average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this baseline. Consumers should be aware of balance billing risks if receiving care from out-of-network providers, though the No Surprises Act protects patients from such unexpected bills for emergency and non-emergency services at in-network facilities. Finally, if a bill is received, patients should request a detailed itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of