CT scan, head (with contrast)
Facility: Girard Medical Center
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $875
- Cash Discount Price: $1,500
- vs. Medicare Baseline: 4.88x 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 488% of the Medicare baseline (a markup of 388%). 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 | $480 - $875 | 268% |
| Medicare (plans) | $875 | 488% |
| UnitedHealthcare | $875 - $2,375 | 488% |
| Ambetter / Centene | $875 | 488% |
| Humana | $875 | 488% |
| Kansas Superior Select-All Plans | $875 | 488% |
| Aetna | $875 - $4,375 | 488% |
| Multiplan-All Plans | $2,312 | 1290% |
| Uhhis-All Plans | $2,375 | 1325% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast at Girard Medical Center in Kansas, the facility's cash median rate is $1,500.00, while the median negotiated rate across insurance plans is $875.00. This facility, a Critical Access Hospital in the Government - Hospital District or Authority ownership, reports a Medicare benchmark of $179.20, which serves as the objective baseline for evaluating pricing markups. Although the negotiated rate is lower than the cash price, patients with high-deductible plans may find the cash option more cost-effective if their insurance allowed amount exceeds $1,500.00. It is important to note that while the facility offers a cash median of $1,500.00, the data does not provide specific county or state average comparisons for this procedure, so patients should verify local pricing trends directly with the hospital or state health department.
Insurance coverage varies significantly among the nine payers listed, with negotiated rates ranging from $480.00 for Blue Cross Blue Shield to $4,375.00 for Aetna. Medicare plans show a consistent rate of $875.00, while UnitedHealthcare and Aetna have a wider range of $875.00 to $2,375.00 and $875.00 to $4,375.00, respectively. Because these rates are contractually agreed upon and include administrative costs, they often differ from the facility's gross charge of $2,500.00. Patients should be aware that