CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Garnet Health Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $391
Cash Discount Price: $427
vs. Medicare Baseline: 2.18x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Garnet Health Medical Center is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.18x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.

Cash / Self-Pay

$427

Average discount available for prompt cash payment at this facility.

Insurance Median

$391

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: $427 (238%)

Insurance Median: $391 (218%)

Cash: $427 (238% of Medicare)

Ins. Median: $391 (218% 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 218% of the Medicare baseline (a markup of 118%). 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
Aetna	$219 - $398	122%
Fidelis	$223	124%
Wellcare	$224	125%
Magnacare	$277 - $443	155%
UnitedHealthcare	$289	161%
Mvp	$360	201%
Rojw	$383	214%
Local 1199	$398	222%
Northwell Direct	$449	251%
Emblem Health	$512	286%
Geisinger Health Plan	$547	305%
Blue Cross Blue Shield	$1,176 - $1,720	656%

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 $427.
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 Garnet Health 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.