CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Marshall Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $557
Cash Discount Price: $687
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Marshall Medical Center is $557. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $687. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.11x the Medicare baseline. Located in 1080 North Ellington Parkway, Lewisburg, TN.

Cash / Self-Pay

$687

Average discount available for prompt cash payment at this facility.

Insurance Median

$557

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: $687 (383%)

Insurance Median: $557 (311%)

Cash: $687 (383% of Medicare)

Ins. Median: $557 (311% 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 311% of the Medicare baseline (a markup of 211%). 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
UnitedHealthcare	$124 - $161	69%
Blue Cross Blue Shield	$216 - $295	121%
Humana	$383 - $750	214%
Wayne County Jail	$730	407%
Marshall County Jail	$1,096	612%
Multiplan	$1,169	652%
Phcs	$1,169	652%
Firsthealth	$1,242	693%
Aetna	$1,315	734%

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 $687.
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 Marshall 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.