CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Sanford Hillsboro

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,816
Cash Discount Price: $1,761
vs. Medicare Baseline: 10.13x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Sanford Hillsboro is $1,816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,761. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 10.13x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$1,761

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,816

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: $1,761 (983%)

Insurance Median: $1,816 (1013%)

Cash: $1,761 (983% of Medicare)

Ins. Median: $1,816 (1013% 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 1013% of the Medicare baseline (a markup of 913%). 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 - $1,429	249%
Sanford Health Plan Align	$1,004	560%
Ucare	$1,078 - $1,934	602%
Aetna	$1,087 - $1,913	607%
Health Partners	$1,087 - $1,717	607%
Medicare (plans)	$1,087	607%
UnitedHealthcare	$1,087 - $1,838	607%
Primewest	$1,109	619%
Security Health Plan	$1,211	676%
Sanford Health Plan	$1,737 - $2,044	969%
Medica	$1,816 - $1,941	1013%
First Choice Health Network	$1,981	1105%
Healthez	$1,981	1105%
Multiplan	$1,981	1105%

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 $1,761.
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 Sanford Hillsboro 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.