CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $1,534
  • Cash Discount Price: $2,691
  • vs. Medicare Baseline: 8.56x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Nemours Children's Hospital, Delaware is $1,534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,691. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 8.56x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$2,691

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,534

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: $2,691 (1502%)
Insurance Median: $1,534 (856%)
Cash: $2,691 (1502% of Medicare)
Ins. Median: $1,534 (856% 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 856% of the Medicare baseline (a markup of 756%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Us Family Health Plan $68 38%
Tricare $186 104%
Celtic Transplant $298 - $2,691 166%
Keystone First Hlth Plan $537 - $1,191 300%
Celtic Transplant For De First Health $942 526%
UnitedHealthcare $988 - $1,679 551%
Wellpoint Maryland $996 556%
Kidz Partners $1,018 568%
Health Partners $1,044 583%
Upmc $1,066 595%
Fidelis $1,076 600%
Aetna $1,142 - $1,561 637%
Blue Cross Blue Shield $1,181 - $2,376 659%
Priority Partners John Hopkins $1,320 737%
Six Degrees Health Transplant $1,346 751%
Cigna $1,480 - $1,695 826%
Great West-One Health Plan $1,480 - $1,695 826%
Ambetter / Centene $1,534 856%
Amerihealth Caritas Delaware $1,534 856%
Geisinger Health Plan $1,615 901%
Integra Administrative Group $1,615 901%
National Transplant Network (Ntn) $1,749 976%
Six Degrees Health $1,749 976%
Star Healthcare Network $1,749 976%
Life Trac Solid Organ And Bmt Transplant $1,884 1051%
First Health Network $2,556 1426%
Insurance Administrators Of America $2,556 1426%
Interlink Transplant Network $2,556 1426%
Multiplan $2,556 1426%
Preferred Healthcare $2,556 1426%
Private Healthcare Systems $2,556 1426%
Three Rivers Provider Network $2,556 1426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens