CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Essentia Health Sandstone

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $825
Cash Discount Price: $1,298
vs. Medicare Baseline: 4.60x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Essentia Health Sandstone is $825. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,298. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.60x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.

Cash / Self-Pay

$1,298

Average discount available for prompt cash payment at this facility.

Insurance Median

$825

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: $1,298 (724%)

Insurance Median: $825 (460%)

Cash: $1,298 (724% of Medicare)

Ins. Median: $825 (460% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 460% of the Medicare baseline (a markup of 360%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Primewest	$177	99%
Itasca Med Care	$178	99%
Blue Cross Blue Shield	$674 - $1,410	376%
Blue Plus Pmap Pcc Prime	$674	376%
Medica Access	$699	390%
Healthpartners Care Pmap	$706	394%
Sanford Healthplan	$753 - $793	420%
Advocare/Security Health	$825	460%
Freedom Blue Ppo	$825	460%
Healthpartners Care Msho / Mcr Adv	$825	460%
Imcare Msho Pcc Prime	$825	460%
Imcare Msho Ref Req	$825	460%
Medica Advantage Solutions	$825	460%
Medica Msho/Dual Solutions	$825	460%
Medica Prime Solution Group	$825	460%
Medicare (plans)	$825	460%
Nd Va Administration	$825	460%
Platinum Blue/Vantage Blue	$825	460%
Primewest Msho	$825	460%
Secure Blue Msho	$825	460%
Ubh Cost Plan	$825	460%
Ubh Msho	$825	460%
Ucare Msho	$825	460%
UnitedHealthcare	$825 - $1,598	460%
Ucare	$1,155	645%
Healthpartners	$1,187 - $1,370	662%
Medica	$1,256 - $1,396	701%
Medica Uplan	$1,256	701%
Wea	$1,264 - $1,352	705%
America'S Ppo	$1,361	759%
Cigna	$1,370	765%
Healthpartners Pcc Prime	$1,370	765%
Medica Choice	$1,438	802%
Wps	$1,475	823%
Aetna	$1,493	833%
Security Health	$1,756	980%

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 $1,298.
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 Essentia Health Sandstone 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.