CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Froedtert Memorial Lutheran Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,055
Cash Discount Price: $1,438
vs. Medicare Baseline: 11.47x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Froedtert Memorial Lutheran Hospital is $2,055. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,438. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 11.47x the Medicare baseline. Located in 9200 W Wisconsin Ave, Milwaukee, WI.

Cash / Self-Pay

$1,438

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,055

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: $1,438 (802%)

Insurance Median: $2,055 (1147%)

Cash: $1,438 (802% of Medicare)

Ins. Median: $2,055 (1147% 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 1147% of the Medicare baseline (a markup of 1047%). 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	$181 - $3,174	101%
Community Care	$181	101%
Health Partners	$181 - $2,315	101%
Humana	$181	101%
Icare	$181	101%
Molina	$181	101%
Network Health Plan	$181 - $1,033	101%
Priority Health	$181	101%
Quartz	$181	101%
Security Health Plan	$181 - $2,936	101%
UnitedHealthcare	$181 - $1,621	101%
Upper Peninsula Health Plan	$181	101%
Aetna	$185 - $2,427	103%
Wellcare	$185	103%
Care Wisconsin/Mychoice	$186	104%
Centivo	$784 - $1,232	438%
Medical College Of Wisconsin	$863 - $1,232	482%
Chorus Community Health Plan	$1,019 - $1,456	569%
Froedtert South	$1,046 - $1,494	584%
Sheboygan Employers Health Network	$1,084	605%
Wisconsin Physician Services Statewide Alliance	$1,647 - $2,352	919%
Trilogy	$1,699 - $2,427	948%
Health Payment Systems	$1,720 - $2,457	960%
Cigna	$2,039 - $2,913	1138%
Dean Health Plan	$2,091 - $2,987	1167%
Group Health Cooperative	$2,091 - $2,987	1167%
Healtheos	$2,091 - $2,987	1167%
Multiplan/Private Healthcare Systems	$2,091 - $2,987	1167%
Healthsmart	$2,170 - $3,099	1211%
Wisconsin Physician Services	$2,222 - $3,174	1240%
First Health Network	$2,261 - $3,230	1262%

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 $1,438.
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 Froedtert Memorial Lutheran 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.