CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Essentia Health Ada

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,032
Cash Discount Price: $1,590
vs. Medicare Baseline: 5.76x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Essentia Health Ada is $1,032. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,590. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.76x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.

Cash / Self-Pay

$1,590

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,032

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: $1,590 (887%)

Insurance Median: $1,032 (576%)

Cash: $1,590 (887% of Medicare)

Ins. Median: $1,032 (576% 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 576% of the Medicare baseline (a markup of 476%). 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%
Healthpartners Care Pmap	$837	467%
Medica Access	$856	478%
Sanford Health Plan	$923 - $971	515%
Advocare/Security Health	$1,032	576%
Blue Cross Blue Shield	$1,032 - $1,875	576%
Freedom Blue Ppo	$1,032	576%
Healthpartners Care Msho / Mcr Adv	$1,032	576%
Imcare Msho Pcc Prime	$1,032	576%
Imcare Msho Ref Req	$1,032	576%
Medica Advantage Solutions	$1,032	576%
Medica Msho/Dual Solutions	$1,032	576%
Medica Prime Solution Group	$1,032	576%
Medicare (plans)	$1,032	576%
Nd Va Administration	$1,032	576%
Platinum Blue/Vantage Blue	$1,032	576%
Primewest Msho	$1,032	576%
Secure Blue Msho	$1,032	576%
Ubh Cost Plan	$1,032	576%
Ubh Msho	$1,032	576%
Ucare Msho	$1,032	576%
UnitedHealthcare	$1,032 - $1,947	576%
Healthpartners	$1,308 - $1,430	730%
Ucare	$1,415	790%
Cigna	$1,430	798%
Healthpartners Pcc Prime	$1,430	798%
Wea	$1,549 - $1,656	864%
America'S Ppo	$1,667	930%
Medica	$1,787 - $1,882	997%
Medica Uplan	$1,787	997%
Wps	$1,807	1008%
Aetna	$1,828	1020%
Blue Plus Pmap Pcc Prime	$1,875	1046%
Medica Choice	$1,938	1081%

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 $1,590.
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 Essentia Health Ada 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.