CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,204
  • Cash Discount Price: $2,113
  • vs. Medicare Baseline: 6.72x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Nemours Children's Hospital, Delaware is $1,204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,113. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 6.72x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$2,113

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,204

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: $2,113 (1179%)
Insurance Median: $1,204 (672%)
Cash: $2,113 (1179% of Medicare)
Ins. Median: $1,204 (672% 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 672% of the Medicare baseline (a markup of 572%). 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 $58 32%
Tricare $186 104%
Celtic Transplant $255 - $2,113 142%
Keystone First Hlth Plan $422 - $935 235%
Celtic Transplant For De First Health $740 413%
UnitedHealthcare $775 - $1,319 432%
Wellpoint Maryland $782 436%
Kidz Partners $799 446%
Health Partners $820 458%
Upmc $837 467%
Fidelis $845 472%
Aetna $896 - $1,226 500%
Blue Cross Blue Shield $927 - $1,866 517%
Priority Partners John Hopkins $1,036 578%
Six Degrees Health Transplant $1,056 589%
Cigna $1,162 - $1,331 648%
Great West-One Health Plan $1,162 - $1,331 648%
Ambetter / Centene $1,204 672%
Amerihealth Caritas Delaware $1,204 672%
Geisinger Health Plan $1,268 708%
Integra Administrative Group $1,268 708%
National Transplant Network (Ntn) $1,373 766%
Six Degrees Health $1,373 766%
Star Healthcare Network $1,373 766%
Life Trac Solid Organ And Bmt Transplant $1,479 825%
First Health Network $2,007 1120%
Insurance Administrators Of America $2,007 1120%
Interlink Transplant Network $2,007 1120%
Multiplan $2,007 1120%
Preferred Healthcare $2,007 1120%
Private Healthcare Systems $2,007 1120%
Three Rivers Provider Network $2,007 1120%

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