CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,851
Cash Discount Price: $1,261
vs. Medicare Baseline: 10.33x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Carilion Stonewall Jackson Hospital is $1,851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,261. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 10.33x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.

Cash / Self-Pay

$1,261

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,851

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: $1,261 (704%)

Insurance Median: $1,851 (1033%)

Cash: $1,261 (704% of Medicare)

Ins. Median: $1,851 (1033% 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 1033% of the Medicare baseline (a markup of 933%). 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	$154 - $2,393	86%
Humana	$157 - $167	88%
Blue Cross Blue Shield	$159 - $819	89%
Sentara Health Plan	$162 - $2,234	90%
Abh of VA (Formerly Coventry)	$167	93%
Abh of Wva (Formerly Coventry)	$167	93%
UnitedHealthcare	$167 - $2,946	93%
Gateway - Tier 3	$1,982	1106%
Vhn - Ultra	$2,234	1247%
Connecticare	$2,523	1408%
Gateway - Tier 2	$2,883	1609%
Vhn - Plus	$2,883	1609%
Cigna	$2,887	1611%
Integrated Health Plan	$3,063	1709%
Vhn	$3,063	1709%
Vhn - Link	$3,244	1810%
Beech Street	$3,316	1850%
Gateway - Tier 1	$3,424	1911%
Vhn - Secondary Payors	$3,424	1911%

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 $1,261.
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 Carilion Stonewall Jackson 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.