CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $832
Cash Discount Price: $646
vs. Medicare Baseline: 7.79x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Alice Peck Day Memorial Hospital is $832. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $646. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.79x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$646

Average discount available for prompt cash payment at this facility.

Insurance Median

$832

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: $646 (605%)

Insurance Median: $832 (779%)

Cash: $646 (605% of Medicare)

Ins. Median: $832 (779% 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 779% of the Medicare baseline (a markup of 679%). 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
Ambetter / Centene	$32	30%
Nh Healthy Families	$33	31%
Medicaid / KanCare	$550	515%
Blue Cross Blue Shield	$552 - $1,067	517%
Wellpoint	$552	517%
Harvard Pilgrim	$746 - $1,040	698%
Cigna	$784 - $981	734%
Klais	$784	734%
Commercial Generic	$832	779%
Connecticut General	$832	779%
UnitedHealthcare	$863	808%
Tufts	$879	823%
Aetna	$1,079	1010%
Mvp	$1,091	1021%
Coventry Health	$1,139	1066%
Coventry Health Wc	$1,139	1066%
Humana	$1,247	1167%

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 $646.
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 Alice Peck Day 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.