CT scan, head (with contrast)
Facility: Fredonia Regional Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $632
- Cash Discount Price: $702
- vs. Medicare Baseline: 3.53x 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 353% of the Medicare baseline (a markup of 253%). 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 | $347 - $480 | 194% |
| Veterans Programs - All Plans | $358 | 200% |
| Aetna | $358 - $632 | 200% |
| UnitedHealthcare | $358 - $632 | 200% |
| Meritain-All Plans | $632 | 353% |
| Cigna | $632 | 353% |
| Reserve National-All Plans | $632 | 353% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast at Fredonia Regional Hospital in Kansas, the cash price is $702.00. This cash rate is notably higher than the state average, which is $179.20, and significantly exceeds the Medicare benchmark of $179.20. While commercial insurance payers like Blue Cross Blue Shield and Veterans Programs have negotiated rates ranging from $347 to $632, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash price directly can be more cost-effective than relying on insurance, as the negotiated rates include administrative overhead and contract dynamics that inflate the baseline price.
Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total cost by bypassing the costly insurance claims process. It is important to note that while the facility is a Critical Access Hospital with government local ownership, the gross charge of $702.00 serves as the starting point for any billing discussion. To ensure you are not overcharged, request an itemized bill that breaks down every CPT code and unit cost, as summary bills often obscure errors or unbundled charges. Disputing any discrepancies in writing with the billing supervisor is the most effective way to reduce medical debt, ensuring you only pay for services rendered at fair market rates rather than inflated list prices.