CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $416
  • Cash Discount Price: $1,723
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Prisma Health Oconee Memorial Hospital is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,723. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.32x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$1,723

Average discount available for prompt cash payment at this facility.

Insurance Median
$416

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: $1,723 (961%)
Insurance Median: $416 (232%)
Cash: $1,723 (961% of Medicare)
Ins. Median: $416 (232% 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 232% of the Medicare baseline (a markup of 132%). 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 - $1,007 100%
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 - $423 100%
Triwest Healthcare Alliance Vcp [902] $179 100%
Va Community Care Network-Vaccn [903] $179 100%
Veterans Administration [3194] $179 100%
Humana $182 - $453 102%
UnitedHealthcare $185 - $851 103%
Aetna $188 - $2,094 105%
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] $379 - $1,361 211%
Medicaid / KanCare $408 - $444 228%
First Choice Benefits Mgmt [3074] $423 236%
Sc Dept Of Corrections [2998] $608 339%
Scdc-Sc Dept Of Corrections [7232] $608 339%
Prisma Health Seniorcare Pace - Midlands [5400] $615 343%
Prisma Health Seniorcare Pace-Upstate [5200] $615 343%
Golden Rule Insurance Company [2991] $851 475%
Oxford Health Plans [2992] $851 475%
Zzumr-Salt Lake City Ut [3169] $851 475%
Promise Health Plan Contracted [2401] $928 - $1,875 518%
Bob Jones Univ-Pai [821] $937 523%
Planned Administrators [820] $1,007 562%
Orangeburg Senior Helping Center Pace [5401] $1,060 592%
Meritain Health Contracted [2200] $1,696 - $2,094 946%
Preferred Administrators Contracted [2839] $1,855 1035%
Medcost [2940] $1,961 - $2,200 1094%
Atlantic Packaging Contracted [4833] $1,988 1109%
Aps Healthcare System [2981] $2,120 1183%
Multiplan/Phcs Contracted [2950] $2,358 1316%
Evernorth Behavioral Contracted [2982] $2,365 1320%
Mvp Health Care [3037] $2,365 1320%
Vsp Vision Care [2986] $2,385 1331%
First Health Contracted [2952] $2,464 1375%
Furman Int/Allen University Student [2951] $2,464 1375%
Quiktrip-First Health [3067] $2,464 1375%

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