CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $174
  • Cash Discount Price: $1,408
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Oakleaf Surgical Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,408. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$1,408

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $1,408 (786%)
Insurance Median: $174 (97%)
Cash: $1,408 (786% of Medicare)
Ins. Median: $174 (97% 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.

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 $174 - $1,748 97%
Dean Health Plan $174 97%
Group Health Cooperative Of Eau Claire $174 97%
Healthpartners $174 97%
Humana $174 97%
Medica $174 97%
Quartz Health Solutions $174 97%
Security Health Plan Of Wi $174 - $876 97%
Ucare Wi $174 97%
UnitedHealthcare $174 97%
Alliance $869 485%

Consumer Guidance & Cost Commentary

For patients paying out-of-pocket, the cash rate for this CT scan of the head is $1,408. While this facility is an Acute Care Hospital in Altoona, Wisconsin, the data indicates that paying cash directly may be the most cost-effective option if your insurance negotiated rate exceeds this amount, as commercial plans often pay significantly higher amounts due to administrative structures. It is important to verify with the hospital whether they offer a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the total cost.

The broader pricing context shows a stark difference between commercial insurance payments and the cash price. The facility's gross charge is listed at $1,564, while the median negotiated rate paid by insurance carriers is $174. For comparison, the Medicare amount for this service is $179.20, which serves as a benchmark for the true cost of delivery. Although the provided data does not include specific county or state average figures for this specific code, the significant gap between the gross charge and the negotiated rate highlights how commercial contracts can differ vastly from the facility's list price, making it essential to understand your specific plan's allowed amount.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals