CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $163
Cash Discount Price: $2,049
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Munson Healthcare Otsego Memorial Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,049. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.91x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$2,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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%)

Cash / Self-Pay: $2,049 (1143%)

Insurance Median: $163 (91%)

Cash: $2,049 (1143% of Medicare)

Ins. Median: $163 (91% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Mclaren Health Plan	$38 - $2,021	21%
Meridian	$38 - $91	21%
Molina	$38 - $189	21%
Priority Health	$38 - $406	21%
UnitedHealthcare	$38 - $1,930	21%
Blue Cross Blue Shield	$39 - $1,505	22%
Blue Care Network	$57 - $175	32%
Hap (Health Alliance Plan)	$57 - $1,928	32%
Humana	$57 - $175	32%
Medicare (plans)	$57 - $175	32%
Michigan Amish Medical Board	$57 - $175	32%
Northern Michigan Mennonite Group	$57 - $175	32%
Aetna	$58 - $1,952	32%
Asr Physicians Care Network	$86 - $1,928	48%
Cigna	$90 - $406	50%
Nomi Health	$92 - $1,928	51%
Employee Benefit Logistics	$98 - $297	55%
Munson Hospice	$852 - $1,687	475%
Hospice Of Michigan	$1,446	807%
Enterprise Group Planning/Employee Benefit Plan	$1,928	1076%
Cofinity	$2,048	1143%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$2,048	1143%
Three Rivers Provider Network	$2,048	1143%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,049.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Munson Healthcare Otsego Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.