CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,752
Cash Discount Price: $4,273
vs. Medicare Baseline: 9.78x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Transylvania Regional Hospital, Inc is $1,752. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,273. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.78x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$4,273

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,752

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: $4,273 (2384%)

Insurance Median: $1,752 (978%)

Cash: $4,273 (2384% of Medicare)

Ins. Median: $1,752 (978% 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 978% of the Medicare baseline (a markup of 878%). 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	$807 - $855	450%
United	$819 - $1,923	457%
Wellcare	$832	464%
Amerihealth	$840	469%
Partners Health Management	$847	473%
Vaya Health	$847	473%
Apex Health	$855	477%
Aetna	$1,111 - $3,090	620%
Cigna	$1,564 - $2,175	873%
Amerihealth Caritas	$1,752	978%
Caresource	$1,880	1049%
Medcost	$2,391 - $3,632	1334%
Magellan	$2,564	1431%
Magellan Behavioral Health	$2,564	1431%
Multiplan	$3,419	1908%
Avalon Administrative Services	$3,632	2027%
Prime Health	$3,760 - $3,846	2098%

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 $4,273.
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 Transylvania Regional Hospital, Inc 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.