CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Prisma Health Tuomey Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $469
  • Cash Discount Price: $1,969
  • vs. Medicare Baseline: 2.62x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Prisma Health Tuomey Hospital is $469. 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 2.62x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$1,969

Average discount available for prompt cash payment at this facility.

Insurance Median
$469

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: $469 (262%)
Cash: $1,969 (1099% of Medicare)
Ins. Median: $469 (262% 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 262% of the Medicare baseline (a markup of 162%). 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 $164 - $1,781 92%
Cigna $164 - $2,258 92%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $164 92%
Humana $164 - $2,272 92%
Medicare (plans) $164 - $172 92%
Triwest Healthcare Alliance Vcp [902] $164 92%
Va Community Care Network-Vaccn [903] $164 92%
Tricare $167 93%
UnitedHealthcare $170 - $466 95%
Aetna $172 - $2,393 96%
Healthy Conn Prime-First Choice Vip Care [5300] $172 96%
Healthy Conn Prime-Molina Healthcare [5330] $172 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $172 96%
Workers Comp [600] $230 128%
Ambetter / Centene $302 169%
Medicaid / KanCare $370 - $482 206%
Golden Rule Insurance Company [2991] $406 227%
Oxford Health Plans [2992] $406 227%
Zzumr-Salt Lake City Ut [3169] $406 227%
Bluechoice [810] $437 - $1,781 244%
Scdc-Sc Dept Of Corrections [7232] $597 333%
Prisma Health Seniorcare Pace - Midlands [5400] $703 392%
Prisma Health Seniorcare Pace-Upstate [5200] $703 392%
Bob Jones Univ-Pai [821] $1,050 586%
Promise Health Plan Contracted [2401] $1,060 - $1,875 592%
Orangeburg Senior Helping Center Pace [5401] $1,212 676%
Planned Administrators [820] $1,781 994%
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%
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: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals