CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Sycamore Shoals Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $387
Cash Discount Price: $588
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Sycamore Shoals Hospital is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.16x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.

Cash / Self-Pay

$588

Average discount available for prompt cash payment at this facility.

Insurance Median

$387

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: $588 (328%)

Insurance Median: $387 (216%)

Cash: $588 (328% of Medicare)

Ins. Median: $387 (216% 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 216% of the Medicare baseline (a markup of 116%). 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
Aetna	$159 - $2,500	89%
Amerigroup	$159 - $233	89%
Humana	$159	89%
Managed Medicaire	$159	89%
Medicare (plans)	$159	89%
Sentara Health	$159 - $1,090	89%
United Mine Workers Of America	$159	89%
UnitedHealthcare	$159 - $3,820	89%
Blue Cross Blue Shield	$164 - $756	92%
Molina Healthcare	$166 - $459	93%
Cigna	$167 - $542	93%
Devoted Health Plan	$167	93%
Nhc Advantage	$167	93%
Wellcare	$169 - $3,918	94%
Ambetter / Centene	$347	194%
Optima Health	$442	247%
Medcost	$1,371	765%
First Health Coventry	$2,938	1640%
Seven Corners, Inc.	$3,918	2186%

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 $588.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sycamore Shoals Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.