CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,510
Cash Discount Price: $1,029
vs. Medicare Baseline: 8.43x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Carilion Stonewall Jackson Hospital is $1,510. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,029. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 8.43x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.

Cash / Self-Pay

$1,029

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,510

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: $1,029 (574%)

Insurance Median: $1,510 (843%)

Cash: $1,029 (574% of Medicare)

Ins. Median: $1,510 (843% 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 843% of the Medicare baseline (a markup of 743%). 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
Blue Cross Blue Shield	$136 - $819	76%
Sentara Health Plan	$139 - $1,823	78%
Abh of VA (Formerly Coventry)	$143	80%
Abh of Wva (Formerly Coventry)	$143	80%
Humana	$143 - $167	80%
UnitedHealthcare	$143 - $2,403	80%
Aetna	$154 - $1,952	86%
Gateway - Tier 3	$1,617	902%
Vhn - Ultra	$1,823	1017%
Connecticare	$2,058	1148%
Gateway - Tier 2	$2,352	1313%
Vhn - Plus	$2,352	1313%
Cigna	$2,355	1314%
Integrated Health Plan	$2,499	1395%
Vhn	$2,499	1395%
Vhn - Link	$2,646	1477%
Beech Street	$2,705	1509%
Gateway - Tier 1	$2,793	1559%
Vhn - Secondary Payors	$2,793	1559%

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 $1,029.
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 Carilion Stonewall Jackson Hospital 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.