CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Aurora Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,014
  • Cash Discount Price: $1,570
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Aurora Medical Center is $1,014. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,570. 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
$1,570

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: $1,570 (876%)
Insurance Median: $1,014 (566%)
Cash: $1,570 (876% 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 - $2,644 300%
Blue Cross Blue Shield $556 - $2,669 310%
Healthpartners $796 - $2,355 444%
Molina Exchange $796 444%
Common Ground $812 453%
Centivo $820 458%
Aetna $836 - $2,594 467%
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 - $2,656 949%
Health Eos Plus $1,884 1051%
Health Eos $2,512 1402%

Consumer Guidance & Cost Commentary

The cash median price for this CT scan, head (with contrast) procedure at Aurora Medical Center in Grafton is $1,570. This facility, a voluntary non-profit acute care hospital, has a negotiated rate of $1,014, which is lower than the cash price, though commercial insurance rates vary significantly; for example, UnitedHealthcare plans may pay up to $2,644 while Molina Exchange plans pay $796. While the facility's rating is 5, patients should be aware that cash payment can sometimes be the most cost-effective option for those with high-deductible plans, as the $1,570 cash rate is notably lower than many commercial negotiated rates, such as the $2,656 rate charged by Cigna.

For context, the Medicare amount for this service is $179.20, and the commercial negotiated rate is 5.7 times higher than the Medicare benchmark. Although the data does not provide explicit state or county average figures for comparison, the significant disparity between the $179.20 Medicare rate and the $1,570 cash rate highlights the potential for substantial savings through prompt-pay discounts or self-pay arrangements. Patients are advised to request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payments can bypass administrative claim processing fees and often result in a lower total cost than the standard cash median.

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