CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Lexington Memorial Hospital Inc

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $1,036
Cash Discount Price: $1,164
vs. Medicare Baseline: 9.70x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Lexington Memorial Hospital Inc is $1,036. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,164. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.70x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$1,164

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,036

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,164 (1090%)

Insurance Median: $1,036 (970%)

Cash: $1,164 (1090% of Medicare)

Ins. Median: $1,036 (970% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 970% of the Medicare baseline (a markup of 870%). 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
Amerihealth	$438 - $639	410%
Carolina Complete	$438	410%
Healthy Blue	$438	410%
Partners	$438	410%
UnitedHealthcare	$443 - $1,042	415%
Vaya	$443	415%
Wellcare	$443	415%
Alliance	$447	419%
Trillium	$452	423%
Medcost	$510 - $1,557	477%
Blue Cross Blue Shield	$649 - $1,042	608%
Aetna	$661 - $2,150	619%
Ambetter / Centene	$668	625%
Oscar	$745 - $1,024	698%
Cigna	$1,012 - $1,031	947%
Directnet	$1,375	1287%
Healthgram Lexington Home Brands	$1,675	1568%
Healthgram	$1,862	1743%
Private Healthcare Systems	$1,908	1786%
Beechstreet	$2,048	1917%
Humana	$2,048	1917%
Multiplan	$2,094	1960%
National Provider Network	$2,094	1960%

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 $1,164.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lexington Memorial Hospital Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.