CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Lafayette Regional Health Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,195
Cash Discount Price: $5,227
vs. Medicare Baseline: 12.25x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Lafayette Regional Health Center is $2,195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,227. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 12.25x the Medicare baseline. Located in 1500 State Street, Lexington, MO.

Cash / Self-Pay

$5,227

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,195

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: $5,227 (2917%)

Insurance Median: $2,195 (1225%)

Cash: $5,227 (2917% of Medicare)

Ins. Median: $2,195 (1225% 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 1225% of the Medicare baseline (a markup of 1125%). 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
United	$101 - $2,352	56%
Healthyblue	$103	57%
Medicaid / KanCare	$104	58%
Aetna	$105 - $4,573	59%
Amerigroup	$105	59%
Home State Health Plan	$105	59%
Unicare	$105	59%
Corvel Corporation	$170 - $4,443	95%
Oha Network	$172 - $2,613	96%
Ambetter / Centene	$972	542%
Nhc Advantage	$993	554%
Universal Healthcare	$1,359	758%
Humana	$1,767 - $2,248	986%
Blue Cross Blue Shield	$1,986 - $5,227	1108%
College Park Family Care Center	$2,248	1254%
Oscar	$2,613	1458%
Cigna	$2,986 - $3,732	1666%
Wppa Providrs Care Network	$3,920	2188%
Multiplan	$4,077	2275%
Coventry	$4,171	2328%
Coventry Kc Mo	$4,171	2328%
Cco, Inc.	$4,443	2479%
Focus Healthcare Mgmt, Inc	$4,704	2625%

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 $5,227.
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 Lafayette Regional Health Center 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.