CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Lee County Community Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $583
Cash Discount Price: $577
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Lee County Community Hospital is $583. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $577. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.25x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.

Cash / Self-Pay

$577

Average discount available for prompt cash payment at this facility.

Insurance Median

$583

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: $577 (322%)

Insurance Median: $583 (325%)

Cash: $577 (322% of Medicare)

Ins. Median: $583 (325% 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 325% of the Medicare baseline (a markup of 225%). 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	$301 - $2,507	168%
Cigna	$427 - $2,507	238%
Blue Cross Blue Shield	$435 - $2,507	243%
Aetna	$552 - $2,507	308%
Ambetter / Centene	$552	308%
Amerigroup	$552 - $2,507	308%
Managed Medicaire	$552	308%
Medicare (plans)	$552	308%
Mountain Empire Pace	$552	308%
Sentara Health	$552 - $647	308%
United Mine Workers Of America	$552	308%
Humana	$560	313%
Molina Healthcare	$574 - $606	320%
Devoted Health Plan	$579	323%
Nhc Advantage	$579	323%
Optima Health	$583	325%
Seven Corners, Inc.	$1,324	739%
First Health Coventry	$2,507	1399%
Medcost	$2,507	1399%

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 $577.
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 Lee County Community 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.