CT scan, head (with contrast)
Facility: Bob Wilson Memorial Hospital
Billing Code: 70460 (CPT)
- CPT Billing Code: 70460
- Insurance Median: $1,887
- Cash Discount Price: $924
- vs. Medicare Baseline: 10.53x 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 1053% of the Medicare baseline (a markup of 953%). 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 |
|---|---|---|
| Centura Employee Plan | $337 | 188% |
| Blue Cross Blue Shield | $641 | 358% |
| Humana | $739 | 412% |
| Kansas Health | $739 | 412% |
| UnitedHealthcare | $739 - $1,926 | 412% |
| Aetna | $739 - $1,848 | 412% |
| Medicare (plans) | $739 | 412% |
| Multiplan | $2,079 - $2,148 | 1160% |
| Health Partners Of Kansas | $2,171 | 1211% |
| Wppa | $2,194 | 1224% |
Consumer Guidance & Cost Commentary
For the CPT code 70460, representing a CT scan of the head with contrast, the facility's cash median price is $924.00, which is significantly lower than the gross charge of $2,310.00. While the negotiated rates for commercial payers range from $337 to $2,194, the cash price may offer a better financial option for patients with high-deductible plans who have not yet met their coverage thresholds. It is important to note that the facility's negotiated rate of $1,887.00 is higher than the Medicare benchmark of $179.20, reflecting the typical administrative markup inherent in commercial contracts. Patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely among the ten payers listed, with UnitedHealthcare and Aetna showing the highest variability.
To minimize out-of-pocket costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can bypass costly insurance billing cycles and administrative fees. Although the data does not provide a specific prompt-pay percentage, hospitals often offer reductions of 20% to 50% for immediate payment to avoid bad debt and collection costs. Additionally, if you are concerned about balance billing, remember that the No Surprises Act protects you from being billed for out-of-network services at in-network facilities, though you should still request an itemized bill to ensure no unbundled codes or services not rendered are included. For this procedure, the facility is located in Ulysses, Kansas, and operates as a Critical Access Hospital with voluntary non-profit