CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $1,260
Cash Discount Price: $977
vs. Medicare Baseline: 11.80x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Gundersen St Josephs Hospital and Clinics is $1,260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $977. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.80x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.

Cash / Self-Pay

$977

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,260

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $977 (915%)

Insurance Median: $1,260 (1180%)

Cash: $977 (915% of Medicare)

Ins. Median: $1,260 (1180% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 1180% of the Medicare baseline (a markup of 1080%). 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
Amerigroup	$138	129%
Security Health Plan	$330	309%
Blue Cross Blue Shield	$851 - $2,313	797%
Iowa Total Care	$851	797%
Managed Health Service	$851	797%
Ucare	$875 - $1,346	819%
UnitedHealthcare	$891 - $1,176	834%
Quartz	$917	859%
Alliance	$1,343 - $1,850	1257%
Cigna	$1,379	1291%
Aspirus Arise Health	$1,396	1307%
Humana	$1,430	1339%
Multiplan/Healtheos	$1,463 - $1,598	1370%
Coventry Health Care	$1,598	1496%

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 $977.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gundersen St Josephs Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.