CMS Price Transparency Data

CT scan, head (with contrast)

Facility: St Luke Hospital & Living Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $951
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 5.31x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at St Luke Hospital & Living Center is $951. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.31x the Medicare baseline. Located in 535 South Freeborn, Marion, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$951

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)
Insurance Median: $951 (531%)
Ins. Median: $951 (531% of 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 531% of the Medicare baseline (a markup of 431%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $951 531%
Blue Cross Blue Shield $951 531%
Kansas Department Of Health And Environment $951 531%
Va Ccn $951 531%
Bluestem Pace $951 531%
Humana $951 531%
Ambetter / Centene $961 536%

Consumer Guidance & Cost Commentary

For the CPT code 70460, representing a CT scan of the head with contrast, St Luke Hospital & Living Center in Marion, KS, lists a gross charge of $1,865.00. While the facility's negotiated rate is $951.00, this amount is significantly higher than the cash median, which is not available in the current data. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. Since the cash median is null, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can offer substantial fee reductions for upfront payment.

This service is benchmarked against the Medicare rate of $179.20, showing a variance of 5.3 times the Medicare amount. The facility, a Critical Access Hospital owned by a Government Hospital District, has a median negotiated rate of $951.00 across seven payers, including UnitedHealthcare, Blue Cross Blue Shield, and Humana. Because the negotiated rate is substantially higher than the Medicare benchmark, patients should be aware that commercial rates often include administrative overhead and contract dynamics that inflate the baseline price. To ensure transparency and avoid unexpected costs, consumers should request an itemized billing audit to verify all charges and confirm whether any services rendered were actually billed, as over 80% of hospital bills contain errors that can be corrected through formal dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 535 South Freeborn, Marion, KS 66861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals