CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Astria Toppenish Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $358
Cash Discount Price: $1,832
vs. Medicare Baseline: 3.35x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Astria Toppenish Hospital is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,832. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.35x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.

Cash / Self-Pay

$1,832

Average discount available for prompt cash payment at this facility.

Insurance Median

$358

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,832 (1715%)

Insurance Median: $358 (335%)

Cash: $1,832 (1715% of Medicare)

Ins. Median: $358 (335% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 335% of the Medicare baseline (a markup of 235%). 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	$112 - $2,480	105%
Cigna	$112	105%
Humana	$112 - $2,818	105%
Medicaid / KanCare	$112 - $358	105%
Medicare (plans)	$112 - $2,328	105%
Tricare	$112	105%
Zenith	$113	106%
Li	$116	109%
Ambetter / Centene	$285	267%
UnitedHealthcare	$285 - $2,328	267%
Va	$285	267%
Molina	$290	272%
Molina_Exchange	$370	346%
Kaiser	$443	415%
Regence	$955	894%
Premera	$1,062	994%
Premera_Affordable_Care	$1,062	994%
Chpw_Cascade_Care	$1,775	1662%
First_Choice	$1,944	1820%
Tpsc	$2,198	2058%
Bcchp	$2,818	2638%
Great_Rivers	$2,818	2638%
Healthcomp	$2,818	2638%
Washington_State_Hca	$2,818	2638%

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 $1,832.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Astria Toppenish Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.