CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Lexington Memorial Hospital Inc

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,710
Cash Discount Price: $1,920
vs. Medicare Baseline: 9.54x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Lexington Memorial Hospital Inc is $1,710. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,920. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.54x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$1,920

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,710

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: $1,920 (1071%)

Insurance Median: $1,710 (954%)

Cash: $1,920 (1071% of Medicare)

Ins. Median: $1,710 (954% 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 954% of the Medicare baseline (a markup of 854%). 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	$723 - $1,055	403%
Carolina Complete	$723	403%
Healthy Blue	$723	403%
Partners	$723	403%
UnitedHealthcare	$731 - $1,720	408%
Vaya	$731	408%
Wellcare	$731	408%
Alliance	$738	412%
Trillium	$745	416%
Medcost	$841 - $2,568	469%
Blue Cross Blue Shield	$1,071 - $1,719	598%
Aetna	$1,090 - $3,547	608%
Ambetter / Centene	$1,102	615%
Oscar	$1,228 - $1,689	685%
Cigna	$1,670 - $1,701	932%
Directnet	$2,269	1266%
Healthgram Lexington Home Brands	$2,764	1542%
Healthgram	$3,071	1714%
Private Healthcare Systems	$3,148	1757%
Beechstreet	$3,378	1885%
Humana	$3,378	1885%
Multiplan	$3,455	1928%
National Provider Network	$3,455	1928%

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 $1,920.
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 Lexington Memorial Hospital Inc 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.