CMS Price Transparency Data

CT scan, head (with contrast)

Facility: M Health Fairview St John's Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $167
Cash Discount Price: $480
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at M Health Fairview St John's Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $480. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.93x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$480

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $480 (268%)

Insurance Median: $167 (93%)

Cash: $480 (268% of Medicare)

Ins. Median: $167 (93% 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
Health Partners	$37 - $880	21%
Primewest	$37 - $173	21%
South Country Health Alliance	$37 - $173	21%
Ucare	$37 - $403	21%
Medica	$39 - $841	22%
Blue Cross Blue Shield	$42 - $518	23%
Itasca Medical Care	$42 - $173	23%
Sanford Health Plan	$50 - $706	28%
Security Health Plan	$50 - $898	28%
UnitedHealthcare	$50 - $593	28%
Wellcare	$50 - $173	28%
Hennepin Health	$56 - $181	31%
America'S Ppo	$147 - $863	82%
First Health	$158 - $982	88%
Multiplan	$164 - $1,018	92%
Private Healthcare Systems	$164 - $1,018	92%
Wisconsin Physician Services	$174 - $1,078	97%

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 $480.
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 M Health Fairview St John's 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.