CMS Price Transparency Data
CT scan, head (with and without contrast)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 70470 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70470
- Insurance Median: $725
- Cash Discount Price: $1,572
- vs. Medicare Baseline: 4.05x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Saint Alphonsus Medical Center Ontario is $725. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,572. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.05x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$1,572
Average discount available for prompt cash payment at this facility.
Insurance Median
$725
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: $1,572 (877%)
Insurance Median: $725 (405%)
Cash: $1,572 (877% of Medicare)
Ins. Median: $725 (405% 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 405% of the Medicare baseline (a markup of 305%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $136 - $725 | 76% |
| Blue Cross Blue Shield | $205 - $2,055 | 114% |
| Medicare (plans) | $205 - $219 | 114% |
| UnitedHealthcare | $205 - $2,321 | 114% |
| Aetna | $211 - $2,290 | 118% |
| American Health Advantage Of Idaho | $213 | 119% |
| Pacificsource Health Plans | $404 - $2,273 | 225% |
| Moda Health | $406 - $2,345 | 227% |
| Healthcare Management Admin | $521 | 291% |
| Blue Benefit Administrators Of Massachusetts | $522 | 291% |
| Blue Care Network | $522 | 291% |
| Blue Distinction Transplant | $522 | 291% |
| Blue Shield - Ca | $522 | 291% |
| Blue Shield - Id (Regence) | $522 | 291% |
| Blue Shield - Ny Highmark Northeastern | $522 | 291% |
| Blue Shield - Ny Highmark Western | $522 | 291% |
| Blue Shield - Pa (Highmark) | $522 | 291% |
| Blue Shield - Wa (Regence) | $522 | 291% |
| Webtpa | $551 - $2,176 | 307% |
| Ada County Jail Inmate Ins | $725 | 405% |
| Ambetter / Centene | $725 | 405% |
| Amish Mennonite | $725 | 405% |
| Bcccp-Michigan | $725 | 405% |
| Bccp | $725 | 405% |
| Bmc Healthnet | $725 | 405% |
| Breast Grant-Connecticut | $725 | 405% |
| California Health And Wellness | $725 | 405% |
| Cardinal Innovations Lme | $725 | 405% |
| Care Oregon Ohp | $725 | 405% |
| Cencal Health Plan | $725 | 405% |
| Cenpatico | $725 | 405% |
| Centurion Of Idaho | $725 | 405% |
| Chhuny | $725 | 405% |
| Childrens Comm Health Plan | $725 | 405% |
| Childrens Medical Services Title 19 | $725 | 405% |
| Cigna | $725 - $2,273 | 405% |
| Community Benefit Health | $725 | 405% |
| Community Care Behavorial Health | $725 | 405% |
| Community Health Choice | $725 | 405% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $725 | 405% |
| Dean Wi Badgercare | $725 | 405% |
| Delaware First Health | $725 | 405% |
| Delta Dental Nj | $725 | 405% |
| Dph Tb Program | $725 | 405% |
| Dscc | $725 | 405% |
| Eastpointe Lme | $725 | 405% |
| Family Health Network | $725 | 405% |
| Freedom First Healthcare | $725 | 405% |
| Ghc Scw Wi Badgercare | $725 | 405% |
| Harbor Health | $725 | 405% |
| Health Safety Net | $725 | 405% |
| Healthy Blue Ne | $725 | 405% |
| Hennepin Health | $725 | 405% |
| Humana | $725 - $2,128 | 405% |
| Id County Ada | $725 | 405% |
| Id County Canyon | $725 | 405% |
| Id County Cat Fund | $725 | 405% |
| Id County Payette | $725 | 405% |
| Idaho Womens Health Check | $725 | 405% |
| Indiana Breast Cervical Cancer | $725 | 405% |
| Inland Empire Health Plan | $725 | 405% |
| Intercommunity Health Ohp | $725 | 405% |
| Iowa Total Care | $725 | 405% |
| Jai Medical System | $725 | 405% |
| Kern Family Health Plan | $725 | 405% |
| Keystone First | $725 | 405% |
| Keystone First Chip | $725 | 405% |
| La Care Health Plan | $725 | 405% |
| Lakeland Care Inc | $725 | 405% |
| Managed Health Services - Indiana | $725 | 405% |
| Maryland Breast & Cervical Program | $725 | 405% |
| Maryland Healthy Smiles - Scion Dental | $725 | 405% |
| Maryland Physicians Care | $725 | 405% |
| Massachusetts Behavioral Health Partnership | $725 | 405% |
| Mdwise | $725 | 405% |
| Medi-Cal | $725 | 405% |
| Medi-Cal Healthnet | $725 | 405% |
| Medstar Dc Healthy Family | $725 | 405% |
| Medstar Md Health Choice | $725 | 405% |
| Mo Home State Health Plan | $725 | 405% |
| Molina Centennial Care | $725 | 405% |
| Nascentia Health Options | $725 | 405% |
| Nebraska Total Care | $725 | 405% |
| New York Cancer Services Program | $725 | 405% |
| Nextlevel Health | $725 | 405% |
| Oregon Screenwise | $725 | 405% |
| Pace Of Southwest Michigan | $725 | 405% |
| Paramount Advantage | $725 | 405% |
| Parkland Community Health Plan | $725 | 405% |
| Partners Behavioral Lme | $725 | 405% |
| Peach State Healthplan | $725 | 405% |
| Presbyterian Centennial Care | $725 | 405% |
| Prestige Health Choice | $725 | 405% |
| Priority Partners | $725 | 405% |
| Rx 340B Pass Along | $725 | 405% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $725 | 405% |
| Rx Medi-Cal | $725 | 405% |
| Rx Meridian Rx | $725 | 405% |
| Sandhills Center Lme | $725 | 405% |
| Screening For Life | $725 | 405% |
| Sunshine State Health Plan | $725 | 405% |
| Superior Health | $725 | 405% |
| Tenncare | $725 | 405% |
| Texas Children'S Health Plan | $725 | 405% |
| Trillium Community Ohp | $725 | 405% |
| Tufts Health Public Plans | $725 | 405% |
| Vaya Health Lme | $725 | 405% |
| Wellsense Health Plan | $725 | 405% |
| Wi Womens Wellness | $725 | 405% |
| Selecthealth | $745 - $2,176 | 416% |
| Mountain Health Co-Op | $1,451 | 810% |
| Allegiance | $1,838 | 1026% |
| Correctional Health Partners | $1,886 | 1052% |
| Columbia Health Network | $1,934 | 1079% |
| Healthnet | $2,031 | 1133% |
| Allied National Global Care | $2,176 | 1214% |
| Asrm - Reliance Standard Life Insurance | $2,176 | 1214% |
| Christian Care Ministry | $2,176 | 1214% |
| Dean Health | $2,176 | 1214% |
| Fallon Health | $2,176 | 1214% |
| Family Life Insurance Company | $2,176 | 1214% |
| First Choice Health | $2,176 | 1214% |
| Ghc Scw | $2,176 | 1214% |
| International Benefit Administrators | $2,176 | 1214% |
| Lifetime Benefit Solutions | $2,176 | 1214% |
| Manhattan Life | $2,176 | 1214% |
| Pai | $2,176 | 1214% |
| Pan-American Life | $2,176 | 1214% |
| Paramount Hmo | $2,176 | 1214% |
| Phcs | $2,176 | 1214% |
| Trinity Health Share | $2,176 | 1214% |
| Lifewise | $2,249 | 1255% |
| Priority Health | $2,273 | 1268% |
| Allied Benefit Systems | $2,290 | 1278% |
| Ameriben | $2,290 | 1278% |
| Asr Health Benefits | $2,290 | 1278% |
| Christian Brother Services | $2,290 | 1278% |
| Geha | $2,290 - $2,321 | 1278% |
| Healthez | $2,290 | 1278% |
| Luminare Health (Detroit) | $2,290 | 1278% |
| Rural Carrier Health Benefit Plan | $2,290 | 1278% |
| First Health | $2,297 | 1282% |
| Medi Share | $2,297 | 1282% |
| Providence | $2,297 | 1282% |