CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Melrosewakefield Healthcare

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $629
  • Cash Discount Price: $793
  • vs. Medicare Baseline: 3.51x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Melrosewakefield Healthcare is $629. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $793. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.51x the Medicare baseline. Located in 585 Lebanon Street, Melrose, MA.
Cash / Self-Pay
$793

Average discount available for prompt cash payment at this facility.

Insurance Median
$629

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: $793 (443%)
Insurance Median: $629 (351%)
Cash: $793 (443% of Medicare)
Ins. Median: $629 (351% 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 351% of the Medicare baseline (a markup of 251%). 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
Meritain [100063] $135 75%
Harvard Pilgrim Healthcare [100241] $202 113%
Health Plans Inc [100262] $202 113%
UnitedHealthcare $202 - $1,948 113%
Allied Benefit Systems [100015] $397 222%
Allied National Global Care [100107] $397 222%
American Postal Workers [100089] $397 222%
Amerihealth Caritas Nh [350007] $397 222%
Assurant [100020] $397 222%
Avmed Health Plan [100247] $397 222%
Benemax [100276] $397 222%
Care One [950007] $397 222%
Carecentrix Alternate [100257] $397 222%
Compsych [100027] $397 222%
Coresource [100285] $397 222%
Coventry [100010] $397 222%
Coverage Discovery [100306] $397 222%
D'Youville Senior Care [950003] $397 222%
Employee Benefit Management [100033] $397 222%
Eyemed [100290] $397 222%
First Health [100278] $397 222%
Geha [100039] $397 222%
Generic Commercial [109999] $397 222%
Group And Pension Administrators [100043] $397 222%
Ibew Local 103 [100272] $397 222%
Lowell Comm Health Center [950009] $397 222%
Medicaid / KanCare $397 - $1,133 222%
Medicare (plans) $397 - $1,133 222%
Mutual Of Omaha [100074] $397 222%
National Association Of Letter Carriers [100067] $397 222%
National Elevator Ind Hlth Benefits [100273] $397 222%
Norfolk County [500013] $397 222%
Northwood Rehabilitation & Health [950004] $397 222%
Nova Healthcare Administrators [100270] $397 222%
Palm Manor [950005] $397 222%
Plymouth County [500019] $397 222%
Spectera [100291] $397 222%
Tall Tree Administrators [100271] $397 222%
Ultra Benefits [100280] $397 222%
Umass Disability [500017] $397 222%
Tufts Health Public Plan Connectorcare [100264] $423 - $597 236%
Health Safety Net [500011] $531 296%
Blue Benefits Administrators [100267] $549 306%
Blue Cross Blue Shield $549 - $1,133 306%
Tufts Health Plan [100263] $549 - $629 306%
Cigna $566 - $629 316%
Wc Acadia Insurance Company [700108] $629 351%
Wc Aig [700029] $629 351%
Wc Aim Mutual Insurance [700054] $629 351%
Wc Alternative Service Concept [700065] $629 351%
Wc Ameritrust [700066] $629 351%
Wc Arrow Mutual Liability [700063] $629 351%
Wc Atlantic Charter [700064] $629 351%
Wc Berkshire Hathaway [700046] $629 351%
Wc Boston Police And Firefighter [700061] $629 351%
Wc Broadspire [700043] $629 351%
Wc Careworks [700109] $629 351%
Wc Cbcs [700110] $629 351%
Wc Ccmsi [700055] $629 351%
Wc Chubb Group [700067] $629 351%
Wc Cic/Mcmc [700068] $629 351%
Wc City Of Boston [700111] $629 351%
Wc City Of Cambridge [700069] $629 351%
Wc City Of Chelsea [700070] $629 351%
Wc City Of Everett [700071] $629 351%
Wc City Of Lowell [700062] $629 351%
Wc City Of Lynn [700072] $629 351%
Wc City Of Medford [700073] $629 351%
Wc City Of Melrose Police [700112] $629 351%
Wc City Of Melrose [700113] $629 351%
Wc City Of Newton [700074] $629 351%
Wc City Of Peabody [700075] $629 351%
Wc City Of Revere [700076] $629 351%
Wc City Of Somerville [700077] $629 351%
Wc Cna [700048] $629 351%
Wc Commonwealth Of Mass [700056] $629 351%
Wc Consigly Construction [700079] $629 351%
Wc Constitution State Services [700114] $629 351%
Wc Continental Indemnity Co [700078] $629 351%
Wc Corvel [700115] $629 351%
Wc Cove Risk Services [700080] $629 351%
Wc Creative Risk Solutions [700081] $629 351%
Wc Crum & Forster [700082] $629 351%
Wc Demoulas Supermarket [700083] $629 351%
Wc Emc Insurance Company [700084] $629 351%
Wc Energy Of Environmental Affairs [700085] $629 351%
Wc Esis [700010] $629 351%
Wc Federated Work Comp [700012] $629 351%
Wc Future Comp [700116] $629 351%
Wc Gallagher Bassett Work Comp [700013] $629 351%
Wc Geico [700057] $629 351%
Wc Generic Workers' Comp [709999] $629 351%
Wc Gowry Group [700086] $629 351%
Wc Hartford Insurance [700058] $629 351%
Wc Hrd/Workers Compensation Unit [700087] $629 351%
Wc Liberty Mutual Work Comp [700016] $629 351%
Wc Mapfre Insurance [700089] $629 351%
Wc Mass Nahro Insurance Group Trust [700090] $629 351%
Wc Mass State Police [700091] $629 351%
Wc Mbta [700092] $629 351%
Wc Meditrol [700093] $629 351%
Wc Memic [700117] $629 351%
Wc Metlife [700094] $629 351%
Wc Miia [700095] $629 351%
Wc Ml Healthcare Services Llc [700119] $629 351%
Wc Norfolk & Dedham Group [700096] $629 351%
Wc Norguard Ins Co [700097] $629 351%
Wc One Call Medical [700060] $629 351%
Wc Plumbers Union Local No 12 [700098] $629 351%
Wc Plymouth Rock [700099] $629 351%
Wc Pma Work Comp [700031] $629 351%
Wc Progressive Direct Insurance Co [700106] $629 351%
Wc Retail Business Services Llc [700100] $629 351%
Wc Rising Medical Solution [700101] $629 351%
Wc Sedgwick [700027] $629 351%
Wc Selective Insurance Co [700118] $629 351%
Wc Sentry [700036] $629 351%
Wc Sutter House [700102] $629 351%
Wc Town Of Andover Fire Dept [700103] $629 351%
Wc Town Of Arlington [700104] $629 351%
Wc Travelers Insurance [700059] $629 351%
Wc Us Department Of Labor [700023] $629 351%
Wc Vermont Mutual Insurance Group [700105] $629 351%
Wc York Risk Services [700049] $629 351%
Wc Zurich [700034] $629 351%
Allaracare [100163] $656 366%
Wellpoint [100139] $797 445%
Claritev/Multiplan [100275] $997 556%
Cypress Benefit Administrators [100122] $997 556%
Health New England [100268] $997 556%
Patient Advocates [100307] $997 556%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 585 Lebanon Street, Melrose, MA 02176
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals