CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $685
Cash Discount Price: $2,735
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UMass Memorial Health - Harrington Hospital is $685. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,735. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.82x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$2,735

Average discount available for prompt cash payment at this facility.

Insurance Median

$685

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: $2,735 (1526%)

Insurance Median: $685 (382%)

Cash: $2,735 (1526% of Medicare)

Ins. Median: $685 (382% 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 382% of the Medicare baseline (a markup of 282%). 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
Champva [11001]	$211	118%
Cigna	$213 - $2,111	119%
Institution [10406]	$213	119%
Mgb Mcr [10124]	$213	119%
Tufts Us Family [11203]	$213	119%
Blue Cross Blue Shield	$220 - $886	123%
Aetna	$223 - $2,735	124%
Commonwealth Care Alliance [10103]	$223	124%
Fallon Mcr Supp [20202]	$223	124%
Fallon Mcr [10105]	$223	124%
Tufts Mcr [10112]	$223	124%
UnitedHealthcare	$223 - $2,735	124%
Senior Whole Health [10110]	$228	127%
Workers Compensation [20501]	$346	193%
Tufts Connectorcare [10507]	$362	202%
Hsno/Free Care [10801]	$681	380%
Wellpoint [11112]	$685	382%
Medicaid / KanCare	$1,422	794%
Hne [11108]	$1,780	993%
First Health Network [11120]	$2,051	1145%
Evernorth Behavioral Health [27]	$2,188	1221%
Connecticare [11105]	$2,735	1526%
Fallon Carelon Hlth [28]	$2,735	1526%
Fallon Mcaid Carelon Hlth [29]	$2,735	1526%
Grants [20507]	$2,735	1526%
Masshealth Mcd Mbhp [38]	$2,735	1526%
Wellsense Mcaid Carelon Hlth [21]	$2,735	1526%

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 $2,735.
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 UMass Memorial Health - Harrington 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.