CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Good Samaritan Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,991
Cash Discount Price: $26,605
vs. Medicare Baseline: 22.27x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Good Samaritan Hospital is $3,991. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,605. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 22.27x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$26,605

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,991

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: $26,605 (14847%)

Insurance Median: $3,991 (2227%)

Cash: $26,605 (14847% of Medicare)

Ins. Median: $3,991 (2227% 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 2227% of the Medicare baseline (a markup of 2127%). 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
Santa Clara Family Health Plan	$109	61%
Physicians Medical Group	$164	92%
Blue Cross Blue Shield	$180 - $951	100%
United	$402 - $6,784	224%
Aetna	$2,044 - $5,074	1141%
Blue Shield	$2,828	1578%
Medcare Partners	$3,991	2227%
Nx Health Network	$15,963	8908%
Sutter Select	$15,963	8908%
Multiplan	$17,293 - $21,284	9650%
Humana	$18,624	10393%
First Health	$20,220 - $26,605	11283%
Cigna	$21,284	11877%
Healthsmart	$21,284 - $22,614	11877%
Intercontinental Corporation	$21,284	11877%
Pha Pacific Health Alliance	$21,284	11877%
Ppo Next	$21,284	11877%

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 $26,605.
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 Good Samaritan Hospital 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.