CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $498
  • Cash Discount Price: $1,969
  • vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Prisma Health Oconee Memorial Hospital is $498. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,969. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.78x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$1,969

Average discount available for prompt cash payment at this facility.

Insurance Median
$498

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: $1,969 (1099%)
Insurance Median: $498 (278%)
Cash: $1,969 (1099% of Medicare)
Ins. Median: $498 (278% 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 278% of the Medicare baseline (a markup of 178%). 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.

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
Tricare $176 98%
Blue Cross Blue Shield $179 - $1,131 100%
Champva [3049] $179 100%
Cigna $179 - $2,365 100%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $179 100%
Deseret Mutual Ins Co [3066] $179 100%
Generic Skilled Nursing [3196] $179 100%
Hospice Contracted [1500] $179 100%
Hospice Non Contracted [3190] $179 100%
Medicare (plans) $179 - $529 100%
Triwest Healthcare Alliance Vcp [902] $179 100%
Va Community Care Network-Vaccn [903] $179 100%
Veterans Administration [3194] $179 100%
Humana $182 - $566 102%
UnitedHealthcare $185 - $851 103%
Aetna $188 - $2,393 105%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $188 105%
Healthy Conn Prime-First Choice Vip Care [5300] $189 105%
Healthy Conn Prime-Molina Healthcare [5330] $196 109%
Workers Comp [600] $250 140%
Ambetter / Centene $329 184%
Bluechoice [810] $342 - $1,528 191%
Medicaid / KanCare $466 - $555 260%
First Choice Benefits Mgmt [3074] $529 295%
Sc Dept Of Corrections [2998] $597 333%
Scdc-Sc Dept Of Corrections [7232] $597 333%
Prisma Health Seniorcare Pace - Midlands [5400] $703 392%
Prisma Health Seniorcare Pace-Upstate [5200] $703 392%
Golden Rule Insurance Company [2991] $851 475%
Oxford Health Plans [2992] $851 475%
Zzumr-Salt Lake City Ut [3169] $851 475%
Bob Jones Univ-Pai [821] $1,050 586%
Promise Health Plan Contracted [2401] $1,060 - $1,875 592%
Planned Administrators [820] $1,131 631%
Orangeburg Senior Helping Center Pace [5401] $1,212 676%
Meritain Health Contracted [2200] $1,939 - $2,393 1082%
Preferred Administrators Contracted [2839] $2,120 1183%
Medcost [2940] $2,241 - $2,514 1251%
Atlantic Packaging Contracted [4833] $2,272 1268%
Evernorth Behavioral Contracted [2982] $2,365 1320%
Mvp Health Care [3037] $2,365 1320%
Aps Healthcare System [2981] $2,423 1352%
Multiplan/Phcs Contracted [2950] $2,696 1504%
Vsp Vision Care [2986] $2,726 1521%
First Health Contracted [2952] $2,817 1572%
Furman Int/Allen University Student [2951] $2,817 1572%
Quiktrip-First Health [3067] $2,817 1572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals