CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,929
Cash Discount Price: $4,823
vs. Medicare Baseline: 10.76x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Nemours Childrens Hospital, Florida is $1,929. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,823. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 10.76x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$4,823

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,929

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: $4,823 (2691%)

Insurance Median: $1,929 (1076%)

Cash: $4,823 (2691% of Medicare)

Ins. Median: $1,929 (1076% 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 1076% of the Medicare baseline (a markup of 976%). 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
Tricare	$179	100%
Aetna	$630	352%
Avmed	$795	444%
Truli	$873 - $1,929	487%
Evolutions Healthcare	$927	517%
Florida Blue	$970 - $2,942	541%
UnitedHealthcare	$1,426	796%
Cigna	$1,443	805%
Employers Health Network Fl	$1,929	1076%
Integra Administrative Group	$2,894	1615%
Global Medical Management	$3,135	1749%
Prime Health Services	$3,135	1749%
Star Healthcare Network	$3,135	1749%
Velocity	$3,617	2018%
First Health Network	$3,762	2099%
Pnoa	$3,858	2153%
Seminole Tribe Of Fl	$3,858	2153%
Private Healthcare Systems	$4,437	2476%

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 $4,823.
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 Nemours Childrens Hospital, Florida 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.