CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Sanford Hillsboro

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $2,364
Cash Discount Price: $2,292
vs. Medicare Baseline: 13.19x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Sanford Hillsboro is $2,364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,292. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 13.19x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$2,292

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,364

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: $2,292 (1279%)

Insurance Median: $2,364 (1319%)

Cash: $2,292 (1279% of Medicare)

Ins. Median: $2,364 (1319% 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 1319% of the Medicare baseline (a markup of 1219%). 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	$447 - $1,860	249%
Sanford Health Plan Align	$1,306	729%
Ucare	$1,404 - $2,517	783%
Aetna	$1,415 - $2,490	790%
Health Partners	$1,415 - $2,235	790%
Medicare (plans)	$1,415	790%
UnitedHealthcare	$1,415 - $2,392	790%
Primewest	$1,444	806%
Security Health Plan	$1,576	879%
Sanford Health Plan	$2,262 - $2,661	1262%
Medica	$2,364 - $2,527	1319%
First Choice Health Network	$2,578	1439%
Healthez	$2,578	1439%
Multiplan	$2,578	1439%

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 $2,292.
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 Sanford Hillsboro 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.