CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Stoughton Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,391
Cash Discount Price: $1,739
vs. Medicare Baseline: 7.76x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Stoughton Hospital is $1,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,739. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.76x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$1,739

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,391

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: $1,739 (970%)

Insurance Median: $1,391 (776%)

Cash: $1,739 (970% of Medicare)

Ins. Median: $1,391 (776% 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 776% of the Medicare baseline (a markup of 676%). 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
Medicaid / KanCare	$392	219%
Tricare	$752	420%
Healthnet Mcr Adv - All Plans	$841	469%
Dean Health Insurance Med Adv	$885	494%
Humana	$885 - $2,845	494%
Quartz Mcr Adv	$885	494%
Security Health/First Health - All Plans	$885	494%
Aetna	$948 - $2,687	529%
Dean Health Insurance Comm - All Other Plans	$1,055	589%
Dean Health Insurance Epo	$1,055	589%
UnitedHealthcare	$1,391 - $2,529	776%
Quartz Health Solutions - All Other Lans	$1,730	965%
Geha - All Plans	$2,371	1323%
Cigna	$2,529	1411%
Wisconsin Ppo Ppa Direct - All Plans	$2,529	1411%
Blue Cross Blue Shield	$2,750	1535%
Wps - All Plans	$2,845	1588%
Alliance - All Plans	$12,644	7056%

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 $1,739.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stoughton Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
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.