CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $140
Cash Discount Price: $1,730
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Munson Healthcare Otsego Memorial Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,730. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.78x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$1,730

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

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: $1,730 (965%)

Insurance Median: $140 (78%)

Cash: $1,730 (965% of Medicare)

Ins. Median: $140 (78% 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	$34 - $1,706	19%
Meridian	$34 - $91	19%
Molina	$34 - $189	19%
Priority Health	$34 - $339	19%
UnitedHealthcare	$34 - $1,630	19%
Blue Cross Blue Shield	$35 - $1,271	20%
Blue Care Network	$51 - $175	28%
Hap (Health Alliance Plan)	$51 - $1,628	28%
Humana	$51 - $175	28%
Medicare (plans)	$51 - $175	28%
Michigan Amish Medical Board	$51 - $175	28%
Northern Michigan Mennonite Group	$51 - $175	28%
Aetna	$52 - $1,648	29%
Asr Physicians Care Network	$77 - $1,628	43%
Cigna	$80 - $339	45%
Nomi Health	$82 - $1,628	46%
Employee Benefit Logistics	$87 - $297	49%
Munson Hospice	$852 - $1,424	475%
Hospice Of Michigan	$1,221	681%
Enterprise Group Planning/Employee Benefit Plan	$1,628	908%
Cofinity	$1,730	965%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$1,730	965%
Three Rivers Provider Network	$1,730	965%

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 $1,730.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

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 70460.
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.