CT

Package

CT

A CT scan (computed tomography) is an imaging procedure that uses a series of x-rays processed by a computer to create detailed 3D images of the inside of the body. During the scan, you pass through a donut-shaped device, and contrast dye may be used to make certain structures more visible, either given through an IV or taken orally. CT scans are billed based on the specific body part being examined. In some cases, images are taken both with and without contrast, or at multiple time intervals, to help distinguish between different types of tissue.

You'd pay up to

$2,296 /

Case Rate

The estimated total cost of care without any insurance coverage or discounts.

Location

Insurance Plan

$2,296

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest

$1,127

Highest

$4,298

Cash price

up to $2,296

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the CT Standard Service Package (SSP RA001). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code	Code Type	Description
HCPCS 73701	Facility Fee	CT Scan of Lower Extremity Using Contrast Material
Revenue Code 270	Facility Fee	Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - General
HCPCS 73590	Facility Fee	X-ray of tibia and fibula, 2 views
HCPCS 73701	Professional Fee	CT Scan of Lower Extremity Using Contrast Material
HCPCS 85025	Facility Fee	Complete blood count (CBC) with differential WBC
HCPCS 80053	Facility Fee	Comprehensive metabolic panel also includes albumin, total protein, ALP, ALT, AST and bilirubin
HCPCS 82550	Facility Fee	Blood test for creatine kinase muscle enzyme (CK/CPK)
HCPCS 36415	Facility Fee	Collection of blood from a vein via puncture
Revenue Code 272	Facility Fee	Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile

Disclaimer

Kahuku Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to

$2,296 /

Case Rate

The estimated total cost of care without any insurance coverage or discounts.

Location

Insurance Plan

Disclaimer

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Service	CT
Service Codes	HCPCS 73701, Revenue Code 270, HCPCS 73590, HCPCS 85025, HCPCS 80053
Insurance	I'm not using insurance
Location	Kahuku Medical Center