CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Aurora Medical Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $1,014
  • Cash Discount Price: $2,305
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Aurora Medical Center is $1,014. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,305. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.66x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
$2,305

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,014

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: $2,305 (1286%)
Insurance Median: $1,014 (566%)
Cash: $2,305 (1286% of Medicare)
Ins. Median: $1,014 (566% 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 566% of the Medicare baseline (a markup of 466%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aurora Caregiver $475 265%
UnitedHealthcare $538 - $3,882 300%
Blue Cross Blue Shield $556 - $3,918 310%
Healthpartners $796 - $3,458 444%
Molina Exchange $796 444%
Common Ground $812 453%
Centivo $820 458%
Aetna $836 - $3,808 467%
Health Payment Systems $875 488%
Quartz One $900 502%
Everpointe Elite $983 549%
Quartz Group $1,000 558%
Hs Technology $1,014 566%
Wisconsin Physician Service $1,128 - $1,187 629%
Trilogy $1,170 653%
Cigna $1,700 - $3,900 949%
Health Eos Plus $2,766 1544%
Health Eos $3,688 2058%

Consumer Guidance & Cost Commentary

Aurora Medical Center, located at 975 Port Washington Road in Grafton, Wisconsin, provides a CT scan of the head (with and without contrast) for a cash price of $2,305. This cash rate is significantly lower than the facility's gross chargemaster of $4,610 and the median negotiated rate of $1,014, which reflects the administrative costs and contractual structures of commercial insurance. While the facility is a voluntary non-profit with a 5-star rating, patients should be aware that insurance plans pay vastly different amounts depending on their carrier; for instance, UnitedHealthcare plans may pay up to $3,882 while Molina Exchange plans pay only $796. It is important to note that the median paid amount is not available in the current data, and the Medicare benchmark for this service is $179.20, which serves as a baseline to understand the markup of commercial rates.

For patients with high-deductible plans, the cash price of $2,305 may be more affordable than the negotiated rates charged to in-network insurance members, as some commercial payers allow amounts exceeding the cash price. To maximize savings, patients should explicitly inquire about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer fee reductions for upfront payment that bypass the higher administrative costs associated with insurance billing. Additionally, if a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they should be cautious of balance billing, which can result in charges for the difference between the provider's full rate and the insurance allowed amount. Federal protections under the No Surprises Act may limit these charges for emergency

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 Port Washington Road, Grafton, WI 53024
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals