CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Fort Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $168
Cash Discount Price: $499
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Fort Memorial Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.94x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$499

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $499 (278%)

Insurance Median: $168 (94%)

Cash: $499 (278% of Medicare)

Ins. Median: $168 (94% 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.

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
Blue Cross Blue Shield	$43 - $955	24%
Mercycare	$48 - $2,002	27%
Dean Health Plan	$50 - $1,574	28%
Humana	$50 - $281	28%
Molina	$50 - $172	28%
Quartz	$50 - $1,493	28%
UnitedHealthcare	$50 - $175	28%
Managed Health Services	$55 - $145	31%
Aetna	$104 - $2,017	58%
Medicaid / KanCare	$133	74%
Alliance	$138 - $1,930	77%
Fort Care	$168 - $482	94%
Medicare (plans)	$172	96%
Centivo	$191 - $1,050	107%
Veteran Evaluation Services	$213	119%
Group Health Cooperative	$239 - $1,740	133%
Trilogy	$346 - $2,365	193%
Cigna	$374 - $2,555	209%

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 $499.
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 Fort Memorial 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.