CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Elmhurst Hospital Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $438
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Elmhurst Hospital Center is $438. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.44x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$438

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%)

Insurance Median: $438 (244%)

Ins. Median: $438 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Healthfirst	$52 - $985	29%
Aetna	$64 - $1,131	36%
Amidacare	$64 - $438	36%
Emblem	$64 - $591	36%
Wellcare	$70 - $215	39%
Metroplus	$83 - $985	46%
Fidelis	$93 - $985	52%
Oscar	$97 - $1,228	54%
Blue Cross Blue Shield	$211 - $985	118%
Vaccn	$211	118%
Vnsny	$211 - $850	118%
Senior Whole Health	$212 - $438	118%
United	$217 - $800	121%
Centers Plan For Healthy Living	$219	122%
Elderplan	$421 - $650	235%
Carelon	$438 - $650	244%
United Behavioral Health	$438 - $482	244%
Affinity	$447 - $985	249%
Carelon (Amida Care)	$447	249%
Centerlight	$500	279%
Oxford	$500 - $600	279%
Magnacare	$750	419%
Multiplan	$800	446%
Local 1199	$850	474%
Villagecare Max	$850	474%
Cigna	$1,056	589%

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 $X.
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 Elmhurst Hospital Center 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.