CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Hermann Area District Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $911
Cash Discount Price: $1,242
vs. Medicare Baseline: 5.08x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Hermann Area District Hospital is $911. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,242. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.08x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$1,242

Average discount available for prompt cash payment at this facility.

Insurance Median

$911

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: $1,242 (693%)

Insurance Median: $911 (508%)

Cash: $1,242 (693% of Medicare)

Ins. Median: $911 (508% 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 508% of the Medicare baseline (a markup of 408%). 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
Healthy Blue Mcaid - All Plans	$244	136%
Ambetter / Centene	$254 - $1,457	142%
Blue Cross Blue Shield	$264 - $1,685	147%
UnitedHealthcare	$264 - $869	147%
Healthlink Hmo	$515	287%
Care Partners Mcaid- All Plans	$562	314%
Healthlink Ppo - All Other Plans	$618	345%
Tricare	$820	458%
Choicecare Mcr Adv- All Plans	$869	485%
American Hlth Mcr Adv- All Plans	$911	508%
Humana	$911	508%
Aetna	$929 - $1,966	518%
Wellcare Mcr Adv - All Plans	$929	518%
Cigna	$1,128	629%
Harmony Hp Mcaid- All Plans	$1,200	670%
Healthcare Usa Mcaid- All Plans	$1,345	751%
Multiplan/Phcs - All Plans	$1,552	866%
Coventry - All Plans	$1,759	982%
Comp Results - All Plans	$1,863	1040%
Three Rivers - All Plans	$1,863	1040%

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 $1,242.
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 Hermann Area District 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.