Forks Community Hospital

ForksClallam CountyCritical Access Hospitals

Head CT scan without contrast

Quality: not rated by CMSEarliest available date: call (360) 374-6271

What you may pay

With insurance from an employer or private plan: $1,768 to $4,119Depends on your plan. Each plan’s price at this hospital:
AMBETTER CCWA EXCH - ALL PLANS $1,768 Higher than typical
COMMUNITY HEALTH EXCHANGE $2,677 Higher than typical
MOLINA COMMERCIAL-ALL OTHER PLANS $3,789 Higher than typical
FIRST CHOICE-ALL PLANS $4,119 Higher than typical
Typical at 45 hospitals we cover: $311 to $1,000 (each hospital’s middle plan price, hospital’s fee). Don’t see your plan? Ask your insurer for its rate here.
Paying yourself (cash price): $3,295 Higher than typicalTypical hospital’s fee at 44 hospitals we cover: $807 to $1,504.Hospital’s fee $2,699 + doctor’s fee $596, both billed by the hospital.

These are prices the hospital published, not a quote. With insurance you usually pay part of the rate (your deductible and coinsurance); the estimator on the procedure page works it out. A higher price does not mean better care.

Doctors usually bill separately. At most hospitals these are the hospital’s own charges. The surgeon, radiologist, anesthesiologist or pathologist usually sends a separate bill: ask each of them for an estimate too.

Source: Forks Community Hospital’s own price file, dated 2026-10-27. CareNavIQ last refreshed prices on 2026-11-09.

Next step: ask the hospital for a Good Faith Estimate for this procedure (phone number above).

Bills to expect

A procedure usually brings several bills, each from whoever did that part of your care. Here is what to expect, with what Traditional Medicare allows for each doctor’s part in this area (Washington outside King County) and an estimate for private plans.

Separate bills for this procedure and their estimated amounts
Bill	Who sends it	How likely	Status	Traditional Medicare allows	Private plans (estimate)
Hospital's feeThe scan: equipment and technologist	The hospital	Expected	Published by the hospital: the prices above	—	—
RadiologistReading the scan and writing the report	The radiology group	Expected	Billed separately; amount estimated	$40	$47 to $71
Ordering doctor's visitThe visit where the CT scan is ordered or the results are explained	Your doctor	Possible	Billed separately; not priced	—	—

What you’d pay for these bills

Adds up your share of the hospital’s bill and the expected doctors’ bills above (not the possible ones). What you type stays in your browser.

Your coverage Insurance from an employer or a private plan Traditional Medicare Medicare Advantage Apple Health (Medicaid)

Your plan’s price at this hospitalDeductible you still have to pay this yearYour coinsurance after the deductibleOut-of-pocket maximum you have left this year (optional)

Your plan’s summary of benefits says how it charges for each kind of care. Leave these as they are if it uses the deductible and coinsurance.

The hospital's billHow your plan charges

The bill from the doctor doing the procedureHow your plan charges

You pay about $363 to $368 of about $1,815 to $1,839 billed to your plan.

Your share of the hospital's bill is about $354; the rest is your share of the doctors' bills. The doctors' bills are estimates. Enter your out-of-pocket maximum to see whether you'd reach it. Assumes everyone is in your network.

How each bill comes to you

Each provider sends a claim to your plan. It applies its allowed amount, then your deductible, copay and coinsurance, and sends you an Explanation of Benefits. Then the provider bills you the “You owe” line. Bills are in the order your plan is assumed to process them, the hospital first. The doctors' bills are estimates.

Show the bills at the lower estimate the higher estimate

Hospital's feeSent by the hospital
The provider's charge
$4,119
Insurance adjustmentWritten off by the provider: you don't owe it.
−$2,351
Allowed amountWhat the insurer counts for this bill.
$1,768
Your plan pays
$1,414
Your coinsurance
$354
You oweThe provider bills you this after the insurer pays.
$354
RadiologistSent by the radiology group
The provider's chargeDoctors don't publish their charges; in network it doesn't change what you owe.
Not published
Allowed amountWhat the insurer counts for this bill.
$47.09
Your plan pays
$37.68
Your coinsurance
$9.42
You oweThe provider bills you this after the insurer pays.
$9.42

All bills: allowed amounts: $1,815
Your plan pays: $1,452
You owe in all: $363

Who owes what, and when you might owe more

The insurance adjustment Written off
An in-network provider agrees to accept your plan's allowed amount. The difference between its charge and that amount is written off: you don't owe it, and it shouldn't appear on your bill.
Deductible You pay
What you pay each year before your plan starts sharing costs. It is applied to bills in the order your plan processes them, so the first bill can take all of it.
Copay You pay
A fixed amount for a kind of care, such as a hospital stay or a surgeon's visit. Your plan's summary of benefits says whether it applies before or after the deductible, and whether a stay's copay is per day.
Coinsurance You pay
Your percentage of the allowed amount after the deductible, such as 20%.
Out-of-pocket maximum Your plan pays
Once your deductible, copays and coinsurance for the year reach it, your plan pays 100% of covered in-network care for the rest of the plan year.
Each provider bills separately You pay
The hospital, surgeon, anesthesia group, radiologist and pathologist each send their own claim and their own bill. All of them count toward the same deductible and yearly maximum.
Out of network and surprise bills It depends
A provider outside your plan's network can bill you the difference between its charge and what your plan pays (a balance bill). It can't for emergency care, or when anesthesia, radiology, pathology, an assistant surgeon or a hospital doctor treats you at an in-network hospital: under federal law (the No Surprises Act) and, for Washington-regulated plans and self-funded plans that opt in, RCW 48.49, those groups cannot balance bill you. Your deductible and coinsurance still apply, at in-network amounts.
Not covered, or no prior authorization It depends
If your plan decides a service isn't covered, or it needed prior authorization that wasn't approved, the plan pays nothing for it and the provider may bill you. Ask the provider to get prior authorization before your care. If an in-network provider didn't get it, the provider's contract may stop it billing you: ask your plan before you pay.
A second insurance It depends
If you have a second plan, the first plan pays first and the second may then pay some or all of your share. These estimates use one plan only.
Wait for the Explanation of Benefits You pay
After each claim your insurer sends an Explanation of Benefits (EOB) with the allowed amount, what it paid and what you may owe. It is not a bill. Pay a provider's bill only when it matches the EOB's “you may owe” amount, and ask the provider or insurer about any difference.
Help from the hospital It depends
Washington hospitals must give free or discounted care based on income, including deductibles and coinsurance for insured patients: free up to 200% or 300% of the federal poverty level depending on the hospital, with discounts above that (RCW 70.170). You can apply after you get a bill. It covers the hospital's bill; doctor groups that bill separately have their own policies.
If you pay yourself instead You pay
You can choose not to use your insurance and pay the cash price; then nothing counts toward your deductible. Ask each provider for a Good Faith Estimate. If a bill is $400 or more above it, you can dispute it within 120 days.

Get it confirmed before your care

The hospital, each doctor’s group and your insurer can each confirm their part in writing. Here is a request for each one, ready to send from your own email, and what to say if you’d rather call. Nothing you do here is saved.

Coming: CareNavIQ will be able to send these for you, follow up, and tell you when everything is confirmed, with your permission.

How you’ll payWith insurancePaying myself, without insurance

Forks Community Hospital

The largest bill.

Request to send

Subject: Estimate request: head ct scan without contrast at Forks Community Hospital

Hello,

I am planning a head ct scan without contrast (billing code CPT 70450) at Forks Community Hospital.

Under Washington law (RCW 70.01.030), I am asking for a written estimate of the hospital's charges, with the billing codes you plan to use.

Name: [YOUR NAME]
Date of birth: [DATE OF BIRTH]
Insurance: [PLAN NAME], member ID [MEMBER ID]
Planned date: [DATE, IF KNOWN]

Thank you.

Replace the words in [brackets] with your details before you send it.

Open in my email

If you call. Call (360) 374-6271 and ask for the price estimate or patient financial services line. Say: "I'd like a written estimate for my head ct scan without contrast."

I’ve sent this one

0 of 3 sent. Washington law gives you the right to these estimates but sets no deadline: if you haven't heard back in five business days, send it again or call.

How these are worked out. Medicare amounts are CMS’s 2026 physician fee schedule for this area, at the rate for care in a hospital. Private-plan estimates are 118% to 179% of Medicare for doctors (the range across 19 studies in KFF’s review of what private insurers pay) and 3 to 5 times Medicare for anesthesia (a published industry estimate). Anesthesia is paid by the minute, so its range assumes the time shown. Medicare pays an assistant at surgery 13.6% to 16% of the surgeon’s fee. Where we have your insurer’s own published rates for the doctors here (below), the estimator uses those for that insurer’s employer plans instead. Your plan’s own rates may be outside these ranges: ask each office for an estimate, and for its network status. At an in-network hospital, the anesthesia, radiology, pathology and assistant groups can’t charge you more than your in-network cost share, even if they are out of network (No Surprises Act).

46 published prices, grouped by who each price applies to.

Cash price 2 prices

The hospital's discounted price for patients paying without insurance.

Cash price prices for Head CT scan without contrast at Forks Community Hospital
Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
$2,699	Hospital’s fee	CT scan head or brain without contrast	—	Outpatient	2026-10-27
$596	Doctor’s fee	CT scan head or brain without contrast	—	Outpatient	2026-10-27

List price (before discounts) 2 prices

The hospital's full chargemaster price. Few patients pay this amount.

List price (before discounts) prices for Head CT scan without contrast at Forks Community Hospital
Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
$3,374	Hospital’s fee	CT scan head or brain without contrast	—	Outpatient	2026-10-27
$745	Doctor’s fee	CT scan head or brain without contrast	—	Outpatient	2026-10-27

Commercial insurance 8 prices

Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Commercial insurance prices for Head CT scan without contrast at Forks Community Hospital
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
AMBETTER CCWA EXCH - ALL PLANS	AMBETTER CCWA EXCH - ALL PLANS	$1,448	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
AMBETTER CCWA EXCH - ALL PLANS	AMBETTER CCWA EXCH - ALL PLANS	$320	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
COMMUNITY HEALTH EXCHANGE	COMMUNITY HEALTH EXCHANGE	$2,193	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
COMMUNITY HEALTH EXCHANGE	COMMUNITY HEALTH EXCHANGE	$484	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
FIRST CHOICE-ALL PLANS	FIRST CHOICE-ALL PLANS	$3,374	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
FIRST CHOICE-ALL PLANS	FIRST CHOICE-ALL PLANS	$745	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
MOLINA COMMERCIAL-ALL OTHER PLANS	MOLINA COMMERCIAL-ALL OTHER PLANS	$3,104	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
MOLINA COMMERCIAL-ALL OTHER PLANS	MOLINA COMMERCIAL-ALL OTHER PLANS	$685	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27

Medicare Advantage 10 prices

Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Medicare Advantage prices for Head CT scan without contrast at Forks Community Hospital
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
COMMUNITY HEALTH NETWORK MCR-ALL OTHER PLANS	COMMUNITY HEALTH NETWORK MCR-ALL OTHER PLANS	$1,248	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
COMMUNITY HEALTH NETWORK MCR-ALL OTHER PLANS	COMMUNITY HEALTH NETWORK MCR-ALL OTHER PLANS	$276	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
HUMANA MCR ADV - ALL PLANS	HUMANA MCR ADV - ALL PLANS	$1,248	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
HUMANA MCR ADV - ALL PLANS	HUMANA MCR ADV - ALL PLANS	$276	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
MOLINA MEDICARE	MOLINA MEDICARE	$557	Hospital’s fee	CT scan head or brain without contrast	fee schedule	Outpatient	2026-10-27
MOLINA MEDICARE	MOLINA MEDICARE	$557	Doctor’s fee	CT scan head or brain without contrast	fee schedule	Outpatient	2026-10-27
UHC MCR ADV	UHC MCR ADV	$1,248	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
UHC MCR ADV	UHC MCR ADV	$276	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
WELLCARE MED ADV - ALL PLANS	WELLCARE MED ADV - ALL PLANS	$1,448	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
WELLCARE MED ADV - ALL PLANS	WELLCARE MED ADV - ALL PLANS	$320	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27

Medicaid managed care 10 prices

Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Medicaid managed care prices for Head CT scan without contrast at Forks Community Hospital
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
AMERIGROUP MEDICAID-ALL PLANS	AMERIGROUP MEDICAID-ALL PLANS	$1,237	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
AMERIGROUP MEDICAID-ALL PLANS	AMERIGROUP MEDICAID-ALL PLANS	$273	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
COORDINATED CARE (MCO) MCD-ALL PLANS	COORDINATED CARE (MCO) MCD-ALL PLANS	$1,260	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
COORDINATED CARE (MCO) MCD-ALL PLANS	COORDINATED CARE (MCO) MCD-ALL PLANS	$278	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
MOLINA MEDICAID	MOLINA MEDICAID	$1,167	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
MOLINA MEDICAID	MOLINA MEDICAID	$258	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
REGENCE MEDICAID	REGENCE MEDICAID	$1,167	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
REGENCE MEDICAID	REGENCE MEDICAID	$258	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
UHC MEDICAID	UHC MEDICAID	$1,502	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
UHC MEDICAID	UHC MEDICAID	$332	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27

Other government program 4 prices

TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

Other government program prices for Head CT scan without contrast at Forks Community Hospital
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
TRICARE-ALL PLANS	TRICARE-ALL PLANS	$1,518	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
TRICARE-ALL PLANS	TRICARE-ALL PLANS	$335	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
TRIWEST-ALL PLANS	TRIWEST-ALL PLANS	$1,248	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
TRIWEST-ALL PLANS	TRIWEST-ALL PLANS	$276	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27

Unknown 10 prices

The source file doesn't say which population this rate applies to.

Unknown prices for Head CT scan without contrast at Forks Community Hospital
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
AETNA-ALL PLANS	AETNA-ALL PLANS	$3,205	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
AETNA-ALL PLANS	AETNA-ALL PLANS	$708	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
CIGNA-ALL PLANS	CIGNA-ALL PLANS	$3,374	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
CIGNA-ALL PLANS	CIGNA-ALL PLANS	$745	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
PREMERA BLUE CROSS-ALL PLANS	PREMERA BLUE CROSS-ALL PLANS	$3,205	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
PREMERA BLUE CROSS-ALL PLANS	PREMERA BLUE CROSS-ALL PLANS	$708	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
REGENCE-ALL OTHER PLANS	REGENCE-ALL OTHER PLANS	$1,943	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
REGENCE-ALL OTHER PLANS	REGENCE-ALL OTHER PLANS	$429	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
UHC ALL PAYER/DOCTORS PLAN/NEXUS-ALL OTHER PLANS	UHC ALL PAYER/DOCTORS PLAN/NEXUS-ALL OTHER PLANS	$2,868	Hospital’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27
UHC ALL PAYER/DOCTORS PLAN/NEXUS-ALL OTHER PLANS	UHC ALL PAYER/DOCTORS PLAN/NEXUS-ALL OTHER PLANS	$633	Doctor’s fee	CT scan head or brain without contrast	percent of total billed charges	Outpatient	2026-10-27

Doctors here who do this procedure

7 doctors affiliated with Forks Community Hospital billed Traditional Medicare for Head CT scan without contrast in 2024, most Medicare services first. See all doctors and practices, including those with no hospital affiliation.

Doctors affiliated with Forks Community Hospital who billed Traditional Medicare for Head CT scan without contrast
Doctor or practice	Practice	Medicare quality score	Times billed to Traditional Medicare (2024)	Traditional Medicare amount for their own service (2024)
Thomas Eggert, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	314	$41.31 at a hospital or surgery center
Robert Deconde, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	235	$41.25 at a hospital or surgery center
Mitsutomi Ishiyama, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	221	$41.26 at a hospital or surgery center
Christopher Goiney, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	196	$41.22 at a hospital or surgery center
Marc Lacrampe, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	175	$41.36 at a hospital or surgery center
Alexi Phinney, MDDiagnostic Radiology · Seattle	Virginia Mason Medical CenterGroup of 867 clinicians	Not rated	125	$41.24 at a hospital or surgery center
Marc Bruce, MDDiagnostic Radiology · Walla Walla	Oregon Healthcare Resources LLCGroup of 159 clinicians	Not rated	65	$38.17 at a hospital or surgery center

Reading the doctor list

A higher price doesn’t mean better care. The quality score and the price come from different CMS files and are shown separately on purpose.
The amount is what Traditional Medicare (original Medicare) approved for the doctor’s or lab’s own service: Medicare’s payment plus the patient’s share. It is not what commercial insurance or Medicare Advantage pays, and the hospital or surgery center bills separately (surgery centers aren’t in this list).
The Medicare quality score is CMS’s MIPS final score (0 to 100), based mostly on the doctor’s Medicare patients. About half of doctors aren’t scored, so Not rated says nothing bad about a doctor. A group’s score covers everyone in the group.
CMS doesn’t publish counts under 11 patients, so doctors who rarely bill Medicare for this aren’t listed, and No price published means CMS has no amount for that setting.
Medicare’s file doesn’t say where a doctor did the procedure, only that they billed it in Washington. Affiliations are the hospitals each doctor lists with Medicare.

See a price that looks wrong? Tell us about it.

Forks Community Hospital

What you may pay

Bills to expect

What you’d pay for these bills

How each bill comes to you

1 Hospital's feeSent by the hospital

2 RadiologistSent by the radiology group

Get it confirmed before your care

Forks Community Hospital

Cash price 2 prices

List price (before discounts) 2 prices

Commercial insurance 8 prices

Medicare Advantage 10 prices

Medicaid managed care 10 prices

Other government program 4 prices

Unknown 10 prices

Doctors here who do this procedure

Reading the doctor list

Hospital's feeSent by the hospital

RadiologistSent by the radiology group