CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Falls Community Hospital and Clinic

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $400
Cash Discount Price: $2,796
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Falls Community Hospital and Clinic is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,796. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.23x the Medicare baseline. Located in 322 Coleman Street, Marlin, TX.

Cash / Self-Pay

$2,796

Average discount available for prompt cash payment at this facility.

Insurance Median

$400

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: $2,796 (1560%)

Insurance Median: $400 (223%)

Cash: $2,796 (1560% of Medicare)

Ins. Median: $400 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Humana	$180	100%
Scott And White	$180	100%
UnitedHealthcare	$180 - $2,446	100%
Cigna	$400	223%
Blue Cross Blue Shield	$866	483%
Aetna	$2,796	1560%

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 $2,796.
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 Falls Community Hospital and Clinic 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.