CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Pender Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $644
Cash Discount Price: $1,012
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Pender Memorial Hospital is $644. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,012. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.59x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$1,012

Average discount available for prompt cash payment at this facility.

Insurance Median

$644

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: $1,012 (565%)

Insurance Median: $644 (359%)

Cash: $1,012 (565% of Medicare)

Ins. Median: $644 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Blue Cross Blue Shield	$263 - $830	147%
Humana	$577 - $1,933	322%
Pace Of The Southern Piedmont	$607	339%
New Hanover Health	$619	345%
Aetna	$622 - $1,911	347%
Cigna	$625 - $991	349%
Carolina Complete	$631	352%
Nc Department Of Public Safety	$631 - $1,214	352%
Amerihealth	$644	359%
Wellcare	$644	359%
Ambetter / Centene	$850	474%
Liberty Health	$862	481%
Caresource North Carolina	$899	502%
Plotkin Health	$1,349	753%
UnitedHealthcare	$1,641	916%
Medcost	$1,693 - $1,886	945%
Employers Choice Network	$2,181	1217%
Three Rivers Provider Network	$2,181	1217%

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 $1,012.
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 Pender Memorial 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.