CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Sanford Vermillion Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,026
Cash Discount Price: $2,299
vs. Medicare Baseline: 11.31x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Sanford Vermillion Medical Center is $2,026. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,299. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 11.31x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$2,299

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,026

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: $2,299 (1283%)

Insurance Median: $2,026 (1131%)

Cash: $2,299 (1283% of Medicare)

Ins. Median: $2,026 (1131% 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 1131% of the Medicare baseline (a markup of 1031%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Sanford Health Plan Align	$848	473%
Wellmark Sd	$874	488%
Ucare	$937 - $2,525	523%
Aetna	$948 - $2,498	529%
Health Partners	$948 - $2,156	529%
Medicare (plans)	$948	529%
UnitedHealthcare	$948 - $2,400	529%
Primewest	$966	539%
Sanford Health Plan	$1,138 - $1,526	635%
Security Health Plan	$1,581	882%
Medica	$2,371 - $2,535	1323%
Wellmark	$2,472 - $2,500	1379%
First Choice Health Network	$2,587	1444%
Healthez	$2,587	1444%
Multiplan	$2,587	1444%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,299.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Vermillion Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.