CMS Price Transparency Data

CT scan, head (with contrast)

Facility: St Francis Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $632
Cash Discount Price: $1,245
vs. Medicare Baseline: 3.53x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at St Francis Hospital is $632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,245. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.53x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.

Cash / Self-Pay

$1,245

Average discount available for prompt cash payment at this facility.

Insurance Median

$632

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: $1,245 (695%)

Insurance Median: $632 (353%)

Cash: $1,245 (695% of Medicare)

Ins. Median: $632 (353% 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 353% of the Medicare baseline (a markup of 253%). 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
Pace-Trinity Health	$183	102%
Saint Francis Life	$183	102%
Blue Cross Blue Shield	$187 - $749	104%
Cigna	$188 - $1,185	105%
Medicare (plans)	$191 - $196	107%
Blue Shield - De (Highmark) Medciare Advantage	$192	107%
Highmark Health Options Dual Plan	$192	107%
Aetna	$198 - $1,245	110%
Coventry	$224	125%
Delaware First Health	$313	175%
Blue Benefit Administrators Of Massachusetts	$632	353%
Blue Care Network	$632	353%
Blue Distinction Transplant	$632	353%
Blue Shield - Ca	$632	353%
Blue Shield - Id (Regence)	$632	353%
Blue Shield - Ny Highmark Northeastern	$632	353%
Blue Shield - Ny Highmark Western	$632	353%
Blue Shield - Pa (Highmark)	$632	353%
Blue Shield - Wa (Regence)	$632	353%
Medicaid / KanCare	$670	374%
Meritain	$1,245	695%
Trustmark Small Business Benefits	$1,245	695%
Devon Health Services	$1,819	1015%
Galaxy Health Network	$1,819	1015%
Multiplan	$1,819	1015%
Prime Health Services	$1,819	1015%
Three Rivers Provider Network	$1,819	1015%
Wc Corvel	$1,819	1015%
Geha	$1,838	1026%
UnitedHealthcare	$1,838	1026%

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 $1,245.
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 St Francis 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.