CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Clara Maass Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $295
Cash Discount Price: $458
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Clara Maass Medical Center is $295. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $458. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.65x the Medicare baseline. Located in One Clara Maass Drive, Belleville, NJ.

Cash / Self-Pay

$458

Average discount available for prompt cash payment at this facility.

Insurance Median

$295

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: $458 (256%)

Insurance Median: $295 (165%)

Cash: $458 (256% of Medicare)

Ins. Median: $295 (165% 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.

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
Aetna	$200 - $322	112%
Fidelis Care	$200 - $299	112%
Clover Health	$200	112%
Humana	$200	112%
Wellpoint	$200 - $1,314	112%
Blue Cross Blue Shield	$200 - $2,200	112%
UnitedHealthcare	$204 - $294	114%
Cigna	$221 - $296	123%
Emblem Health	$350	195%
Amerihealth	$373	208%
Wellcare	$397	222%
Qualcare Inc	$726 - $759	405%
First Health	$1,383	772%

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 $458.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Clara Maass Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
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.