CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Southwest General Health Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $839
Cash Discount Price: $1,495
vs. Medicare Baseline: 4.68x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Southwest General Health Center is $839. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,495. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.68x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$1,495

Average discount available for prompt cash payment at this facility.

Insurance Median

$839

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: $1,495 (834%)

Insurance Median: $839 (468%)

Cash: $1,495 (834% of Medicare)

Ins. Median: $839 (468% 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 468% of the Medicare baseline (a markup of 368%). 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
Medical Mutual	$71 - $77	40%
Medical Mutual-Ohio	$71	40%
Buckeye	$223 - $365	124%
Molina	$223 - $365	124%
Amerihealth Caritas	$365	204%
Blue Cross Blue Shield	$365	204%
Caresource	$365	204%
Humana	$365 - $818	204%
UnitedHealthcare	$365 - $1,133	204%
Healthsmart	$604 - $671	337%
Health Design Plus	$699 - $776	390%
Clarity Health	$755 - $839	421%
Healthspan	$755 - $839	421%
Healthsmart Preferred	$850 - $944	474%
Ohio Health Choice Plus	$914 - $1,015	510%
Summacare	$1,020 - $1,133	569%
Aetna	$1,021 - $1,135	570%
Cigna	$1,033 - $1,148	576%
Coventry	$1,303 - $1,448	727%
First Health	$1,303 - $1,448	727%
Ohio Health Choice	$1,459 - $1,622	814%
Private Healthare Systems	$1,510 - $1,678	843%

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 $1,495.
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 Southwest General Health Center 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.