CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Fort Memorial Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70450
  • Insurance Median: $122
  • Cash Discount Price: $364
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Fort Memorial Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $364. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.
Cash / Self-Pay
$364

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $364 (341%)
Insurance Median: $122 (114%)
Cash: $364 (341% of Medicare)
Ins. Median: $122 (114% 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.

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
Mercycare $36 - $1,438 34%
Blue Cross Blue Shield $37 - $955 35%
Dean Health Plan $38 - $800 36%
Humana $38 - $229 36%
Molina $38 - $108 36%
Quartz $38 - $1,074 36%
UnitedHealthcare $38 - $135 36%
Managed Health Services $47 - $145 44%
Aetna $78 - $1,448 73%
Medicare (plans) $102 95%
Alliance $104 - $1,386 97%
Fort Care $127 - $341 119%
Veteran Evaluation Services $127 119%
Medicaid / KanCare $133 125%
Centivo $156 - $1,050 146%
Group Health Cooperative $195 - $1,249 183%
Trilogy $283 - $1,698 265%
Cigna $306 - $1,835 286%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 Sherman Ave E, Fort Atkinson, WI 53538
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals