CMS Price Transparency Data
CT scan, head (with and without contrast)
Facility: St Charles Madras
Billing Code: 70470 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70470
- Insurance Median: $729
- Cash Discount Price: $2,431
- vs. Medicare Baseline: 4.07x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Charles Madras is $729. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,431. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.07x the Medicare baseline. Located in 470 Ne A Street, Madras, OR.
Cash / Self-Pay
$2,431
Average discount available for prompt cash payment at this facility.
Insurance Median
$729
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: $2,431 (1357%)
Insurance Median: $729 (407%)
Cash: $2,431 (1357% of Medicare)
Ins. Median: $729 (407% 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 407% of the Medicare baseline (a markup of 307%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $141 - $1,246 | 79% |
| Auto Allstate Insurance [602] | $267 | 149% |
| Auto American Family Insurance [603] | $267 | 149% |
| Auto Country Insurance Claims [604] | $267 | 149% |
| Auto Dairyland Insurance [617] | $267 | 149% |
| Auto Farmers [605] | $267 | 149% |
| Auto Geico Claims Oregon [606] | $267 | 149% |
| Auto Hartford [612] | $267 | 149% |
| Auto Liberty Mutual Auto Ins [613] | $267 | 149% |
| Auto Mutual Of Enumclaw [610] | $267 | 149% |
| Auto Nationwide Allied Insuranc [601] | $267 | 149% |
| Auto Oregon Mutual [614] | $267 | 149% |
| Auto Progressive [608] | $267 | 149% |
| Auto Safeco Concentra [600] | $267 | 149% |
| Auto State Farm Claims [609] | $267 | 149% |
| Auto Sublimity Insurance [616] | $267 | 149% |
| Auto Travelers Insurance [615] | $267 | 149% |
| Auto Usaa [611] | $267 | 149% |
| Generic Auto [649] | $267 | 149% |
| Generic Workers Comp [699] | $267 | 149% |
| Otj Broadspire Services [670] | $267 | 149% |
| Otj Ccmsi [618] | $267 | 149% |
| Otj Chartis Claims [650] | $267 | 149% |
| Otj City County Ins Services [662] | $267 | 149% |
| Otj Corvel [676] | $267 | 149% |
| Otj Esis West Wc Claims [653] | $267 | 149% |
| Otj Gallagher Bassett [654] | $267 | 149% |
| Otj Hartford [655] | $267 | 149% |
| Otj Intermountain Claims Inc [666] | $267 | 149% |
| Otj Liberty Mutual Wausau Underwriters [671] | $267 | 149% |
| Otj Penser No American [663] | $267 | 149% |
| Otj Pinnacle Risk Mgmt [661] | $267 | 149% |
| Otj Saif [667] | $267 | 149% |
| Otj Sedgwick Cms [660] | $267 | 149% |
| Otj Sedgwick [668] | $267 | 149% |
| Otj Travelers Insurance [672] | $267 | 149% |
| Otj Tristar [673] | $267 | 149% |
| Blue Cross Blue Shield | $549 - $802 | 306% |
| Bridgespan [342] | $549 | 306% |
| Asuris Northwest Health [202] | $646 | 360% |
| Healthcare Management Admin [201] | $646 | 360% |
| Regence Group Administrators [203] | $646 | 360% |
| Aetna | $729 - $2,644 | 407% |
| Ageright Advantage [142] | $729 | 407% |
| Champ Va [700] | $729 | 407% |
| Cigna | $729 - $1,915 | 407% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $729 | 407% |
| Devoted Health Inc [145] | $729 | 407% |
| Health Market Care Assured [134] | $729 | 407% |
| Health Net Med Adv [135] | $729 | 407% |
| Humana | $729 | 407% |
| Indian Health [704] | $729 | 407% |
| Kaiser Permanente Med Adv [136] | $729 | 407% |
| Law Enforcement [701] | $729 - $1,507 | 407% |
| Medicare (plans) | $729 - $846 | 407% |
| Samaritan Health Plan Med Adv [141] | $729 | 407% |
| Unicare [133] | $729 | 407% |
| UnitedHealthcare | $729 - $2,809 | 407% |
| Veterans [706] | $729 | 407% |
| Wellcare [132] | $729 | 407% |
| Tricare | $949 | 530% |
| Pacificsource [345] | $1,216 - $1,662 | 679% |
| Advanced Health [534] | $1,246 | 695% |
| Allcare Health Plan [538] | $1,246 | 695% |
| Cascade Health Alliance [532] | $1,246 | 695% |
| Columbia Pacific Coordinated Care Llc [539] | $1,246 | 695% |
| Health Share Care Oregon [526] | $1,246 | 695% |
| Health Share Kaiser [543] | $1,246 | 695% |
| Health Share Ohsu Ohp [552] | $1,246 | 695% |
| Health Share Providence [548] | $1,246 | 695% |
| Health Share [537] | $1,246 | 695% |
| Intercommunity Health [530] | $1,246 | 695% |
| Jackson Care Connect [542] | $1,246 | 695% |
| Primary Health Of Jospehine County Llc [547] | $1,246 | 695% |
| Umpqua Health [533] | $1,246 | 695% |
| Willamette Valley Community Health [536] | $1,246 | 695% |
| Yamhill County Coordinated Care Org [550] | $1,246 | 695% |
| Us Benefits [326] | $1,915 | 1069% |
| Providence Health Plan [347] | $2,127 - $2,659 | 1187% |
| Rocky Mountain Administrators [405] | $2,431 | 1357% |
| Rx Internal [4100003] | $2,483 | 1386% |
| Moda [310] | $2,614 | 1459% |
| First Choice Health [317] | $2,632 | 1469% |
| Kaiser Permanente [334] | $2,632 | 1469% |
| Samaritan [376] | $2,632 | 1469% |
| Meritain Health [300] | $2,644 | 1475% |
| Health Net [340] | $2,857 | 1594% |
| Administrative Concepts Inc [402] | $2,978 | 1662% |
| First Health [339] | $2,978 | 1662% |
| Manhattan Life Insurance Company [379] | $2,978 | 1662% |
| Philadelphia American Life Insurance Company [395] | $2,978 | 1662% |
| Planned Administrators Inc [375] | $2,978 | 1662% |