CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $244
Cash Discount Price: $581
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Mary Hitchcock Memorial Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.28x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$581

Average discount available for prompt cash payment at this facility.

Insurance Median

$244

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $581 (544%)

Insurance Median: $244 (228%)

Cash: $581 (544% of Medicare)

Ins. Median: $244 (228% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 228% of the Medicare baseline (a markup of 128%). 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
Wellsense Health Plan	$32 - $346	30%
Beacon Health Strategies/Carelon	$38 - $346	36%
Amerihealth Caritas Nh	$39 - $321	37%
Blue Cross Blue Shield	$39 - $2,793	37%
Granite State Health Plan	$39 - $357	37%
Martin'S Point Generations Advantage	$39 - $119	37%
Mvp	$39 - $1,899	37%
UnitedHealthcare	$39 - $2,177	37%
Aetna	$40 - $1,990	37%
Cigna	$40 - $1,945	37%
Martin'S Point Health Care	$40 - $978	37%
Ambetter / Centene	$41 - $256	38%
Wellcare Health Plans	$41 - $124	38%
Harvard Pilgrim Health Care Of Ne	$49 - $1,819	46%
Mass General Brigham Health Plan	$113 - $1,763	106%
Tufts Health Plan	$131 - $1,654	123%
Maine Community Health Options	$613 - $2,084	574%
Coventry	$838 - $2,466	785%
First Health/Hcvm	$838 - $2,466	785%
Phcs	$867 - $2,552	812%
Corvel	$886 - $2,608	830%
Ccmsi	$915 - $2,693	857%

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 $581.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.