CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Prisma Health Tuomey Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70450
  • Insurance Median: $322
  • Cash Discount Price: $1,396
  • vs. Medicare Baseline: 3.01x Medicare
The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Prisma Health Tuomey Hospital is $322. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,396. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.01x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$1,396

Average discount available for prompt cash payment at this facility.

Insurance Median
$322

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,396 (1307%)
Insurance Median: $322 (301%)
Cash: $1,396 (1307% of Medicare)
Ins. Median: $322 (301% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 301% of the Medicare baseline (a markup of 201%). 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
Blue Cross Blue Shield $98 - $1,049 92%
Cigna $98 - $2,258 92%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $98 92%
Humana $98 - $1,611 92%
Medicare (plans) $98 - $103 92%
Triwest Healthcare Alliance Vcp [902] $98 92%
Va Community Care Network-Vaccn [903] $98 92%
Tricare $100 94%
UnitedHealthcare $101 - $331 95%
Aetna $103 - $1,697 96%
Healthy Conn Prime-First Choice Vip Care [5300] $103 96%
Healthy Conn Prime-Molina Healthcare [5330] $103 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $103 96%
Workers Comp [600] $137 128%
Ambetter / Centene $180 169%
Golden Rule Insurance Company [2991] $240 225%
Oxford Health Plans [2992] $240 225%
Zzumr-Salt Lake City Ut [3169] $240 225%
Medicaid / KanCare $247 - $331 231%
Bluechoice [810] $255 - $1,049 239%
Scdc-Sc Dept Of Corrections [7232] $421 394%
Prisma Health Seniorcare Pace - Midlands [5400] $498 466%
Prisma Health Seniorcare Pace-Upstate [5200] $498 466%
Promise Health Plan Contracted [2401] $752 - $1,875 704%
Bob Jones Univ-Pai [821] $756 708%
Orangeburg Senior Helping Center Pace [5401] $859 804%
Planned Administrators [820] $1,049 982%
Meritain Health Contracted [2200] $1,375 - $1,697 1287%
Preferred Administrators Contracted [2839] $1,504 1408%
Medcost [2940] $1,590 - $1,783 1489%
Atlantic Packaging Contracted [4833] $1,611 1508%
Aps Healthcare System [2981] $1,718 1608%
Multiplan/Phcs Contracted [2950] $1,912 1790%
Vsp Vision Care [2986] $1,933 1810%
First Health Contracted [2952] $1,998 1871%
Furman Int/Allen University Student [2951] $1,998 1871%
Quiktrip-First Health [3067] $1,998 1871%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals