CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Holy Family Memorial

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,360
Cash Discount Price: $1,246
vs. Medicare Baseline: 7.59x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Holy Family Memorial is $1,360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,246. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.59x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$1,246

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,360

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: $1,246 (695%)

Insurance Median: $1,360 (759%)

Cash: $1,246 (695% of Medicare)

Ins. Median: $1,360 (759% 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 759% of the Medicare baseline (a markup of 659%). 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
Blue Cross Blue Shield	$169 - $1,470	94%
Community Care Incorporated	$169	94%
Health Partners	$169 - $1,473	94%
Humana	$169	94%
Icare	$169	94%
Molina	$169 - $183	94%
Network Health Plan	$169 - $1,033	94%
Security Health Plan	$169 - $1,813	94%
UnitedHealthcare	$169 - $1,565	94%
Allwell	$173	97%
Medical College Of Wisconsin	$748	417%
Centivo	$906 - $1,042	506%
Dean Health Plan	$1,133	632%
Health Payment Systems	$1,175	656%
Sheboygan Employers Health Network	$1,360	759%
Chorus Community Health Plan	$1,457	813%
Trilogy	$1,496	835%
Cigna	$1,632	911%
Wps Health Plan	$1,677	936%
Aspirus	$1,813	1012%
Healtheos	$1,813	1012%
Multiplan/Private Healthcare Systems	$1,813	1012%
Preferred One	$1,813	1012%
Healthsmart	$1,881	1050%
First Health Network	$1,994	1113%

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 $1,246.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holy Family Memorial is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.