CT scan, head (with and without contrast)
Facility: Fredonia Regional Hospital
Billing Code: 70470 (CPT)
- CPT Billing Code: 70470
- Insurance Median: $527
- Cash Discount Price: $586
- vs. Medicare Baseline: 2.94x 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 294% of the Medicare baseline (a markup of 194%). 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 | $290 - $480 | 162% |
| UnitedHealthcare | $299 - $527 | 167% |
| Aetna | $299 - $527 | 167% |
| Veterans Programs - All Plans | $299 | 167% |
| Reserve National-All Plans | $527 | 294% |
| Meritain-All Plans | $527 | 294% |
| Cigna | $527 | 294% |
Consumer Guidance & Cost Commentary
For the CPT code 70470, representing a CT scan of the head with and without contrast, Fredonia Regional Hospital in Kansas has a cash median price of $586.00, which matches the facility's gross charge. While the hospital's negotiated rates with major insurers like Blue Cross Blue Shield, UnitedHealthcare, and Aetna range from $290 to $527, the cash price remains the lowest option available for self-pay patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $586.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for some payers can exceed this amount. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which could further reduce the final bill if settled in full before or shortly after the service.
This facility is a Critical Access Hospital in the state of Kansas, and its pricing structure is benchmarked against federal standards. The Medicare amount for this procedure is $179.20, which serves as the objective baseline for evaluating the facility's markup; commercial negotiated rates often average between 200% and 300% of this figure, though fair pricing is typically defined as 120% to 150%. Since the data provided does not include specific county or state average comparisons, patients should focus on comparing the facility's cash rate directly against their own insurance allowed amounts to determine the best financial outcome. If you receive a bill that appears higher than these rates, you may be eligible for an itemized billing audit to identify errors, double-billing, or