CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: St Josephs Community Hospital West Bend

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $2,230
  • Cash Discount Price: $1,994
  • vs. Medicare Baseline: 12.44x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Josephs Community Hospital West Bend is $2,230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,994. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 12.44x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$1,994

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,230

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: $1,994 (1113%)
Insurance Median: $2,230 (1244%)
Cash: $1,994 (1113% of Medicare)
Ins. Median: $2,230 (1244% 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 1244% of the Medicare baseline (a markup of 1144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Allwell $173 97%
Blue Cross Blue Shield $173 - $3,082 97%
Community Care $173 97%
Health Partners $173 - $2,357 97%
Humana $173 97%
Icare $173 97%
Molina $173 97%
Network Health Plan $173 - $1,033 97%
Security Health Plan Secure Savers $173 97%
UnitedHealthcare $173 - $1,565 97%
Aetna $176 - $2,538 98%
Care Wisconsin $178 99%
Centivo $1,088 - $1,197 607%
Froedtert South $1,523 850%
Chorus Community Health Plan $1,559 870%
Sheboygan Employers Health Network $1,791 999%
Common Ground $2,176 1214%
Health Payment Systems $2,284 - $2,931 1275%
Wisconsin Physician Services $2,901 1619%
Trilogy $2,973 1659%
Americas Choice $3,155 1761%
Healtheos $3,155 1761%
Multiplan/Private Healthcare Systems $3,155 1761%
First Health Network $3,191 1781%
Hfn $3,263 1821%
Ibsi Passport $3,263 1821%
Cigna $3,445 1922%
Healthsmart $3,445 1922%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals