CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Forks Community Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $858
Cash Discount Price: $1,803
vs. Medicare Baseline: 4.79x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Forks Community Hospital is $858. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,803. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.79x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$1,803

Average discount available for prompt cash payment at this facility.

Insurance Median

$858

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: $1,803 (1006%)

Insurance Median: $858 (479%)

Cash: $1,803 (1006% of Medicare)

Ins. Median: $858 (479% 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 479% of the Medicare baseline (a markup of 379%). 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
Medicaid / KanCare	$297 - $1,338	166%
Medicare (plans)	$318	177%
Coordinated Care (Mco) Mcd-All Plans	$320 - $1,363	179%
UnitedHealthcare	$382 - $3,102	213%
Community Health Network Mcr-All Other Plans	$386 - $1,642	215%
Humana	$386 - $1,642	215%
Tricare	$386 - $1,642	215%
Triwest-All Plans	$386 - $1,642	215%
Ambetter / Centene	$448 - $1,905	250%
Wellcare Med Adv - All Plans	$448 - $1,905	250%
Regence-All Other Plans	$494 - $2,102	276%
Community Health Exchange	$558 - $2,372	311%
Molina Commercial-All Other Plans	$789 - $3,358	440%
Aetna	$815 - $3,468	455%
Blue Cross Blue Shield	$815 - $3,468	455%
Cigna	$858 - $3,650	479%
First Choice-All Plans	$858 - $3,650	479%

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 $1,803.
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 Forks 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.