CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,878
Cash Discount Price: $1,606
vs. Medicare Baseline: 10.48x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Gundersen Moundview Hospital and Clinics is $1,878. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,606. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 10.48x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.

Cash / Self-Pay

$1,606

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,878

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: $1,606 (896%)

Insurance Median: $1,878 (1048%)

Cash: $1,606 (896% of Medicare)

Ins. Median: $1,878 (1048% 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 1048% of the Medicare baseline (a markup of 948%). 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	77%
Dean Health Plan	$894	499%
Blue Cross Blue Shield	$990 - $2,781	552%
Iowa Total Care	$990	552%
Managed Health Service	$990	552%
UnitedHealthcare	$1,221	681%
Health Partners	$1,440 - $2,764	804%
Security Health Plan	$1,440	804%
Ucare	$1,440 - $2,504	804%
Quartz	$1,706	952%
Wps	$2,413	1347%
Wps - Arise	$2,413	1347%
Alliance	$2,504 - $2,974	1397%
Aspirus Arise Health	$2,598	1450%
Humana	$2,660	1484%
Multiplan/Healtheos	$2,754 - $3,005	1537%
Coventry Health Care	$2,974	1660%

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 $1,606.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gundersen Moundview Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.