CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: St Luke's Warren Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $777
Cash Discount Price: $8,401
vs. Medicare Baseline: 4.34x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Luke's Warren Hospital is $777. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,401. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.34x the Medicare baseline. Located in 185 Roseberry St, Phillipsburg, NJ.

Cash / Self-Pay

$8,401

Average discount available for prompt cash payment at this facility.

Insurance Median

$777

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: $8,401 (4688%)

Insurance Median: $777 (434%)

Cash: $8,401 (4688% of Medicare)

Ins. Median: $777 (434% 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 434% of the Medicare baseline (a markup of 334%). 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
Geisinger	$188 - $2,625	105%
Amerihealth Caritas	$191	107%
UPMC Health Plan	$191 - $2,558	107%
UnitedHealthcare	$196 - $2,502	109%
Blue Cross Blue Shield	$196 - $1,934	109%
Aetna	$200 - $3,258	112%
Humana	$204	114%
Oscar	$2,427	1354%
Cigna	$2,536	1415%

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 $8,401.
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 St Luke's Warren 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.