CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Lee County Community Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $570
Cash Discount Price: $549
vs. Medicare Baseline: 3.18x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Lee County Community Hospital is $570. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $549. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.18x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.

Cash / Self-Pay

$549

Average discount available for prompt cash payment at this facility.

Insurance Median

$570

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: $549 (306%)

Insurance Median: $570 (318%)

Cash: $549 (306% of Medicare)

Ins. Median: $570 (318% 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 318% of the Medicare baseline (a markup of 218%). 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	$270 - $2,388	151%
Blue Cross Blue Shield	$356 - $2,388	199%
Cigna	$427 - $2,388	238%
Aetna	$525 - $2,388	293%
Ambetter / Centene	$525	293%
Amerigroup	$525 - $2,388	293%
Managed Medicaire	$525	293%
Medicare (plans)	$525	293%
Mountain Empire Pace	$525	293%
Sentara Health	$525 - $616	293%
United Mine Workers Of America	$525	293%
Humana	$534	298%
Molina Healthcare	$546 - $606	305%
Devoted Health Plan	$552	308%
Nhc Advantage	$552	308%
Optima Health	$583	325%
Seven Corners, Inc.	$1,261	704%
First Health Coventry	$2,388	1333%
Medcost	$2,388	1333%

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 $549.
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 Lee County Community 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.