CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC Chautauqua at Wca

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $512
Cash Discount Price: $607
vs. Medicare Baseline: 2.86x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC Chautauqua at Wca is $512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $607. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.86x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$607

Average discount available for prompt cash payment at this facility.

Insurance Median

$512

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: $607 (339%)

Insurance Median: $512 (286%)

Cash: $607 (339% of Medicare)

Ins. Median: $512 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Univera	$161	90%
Upmc Health Plan	$168 - $607	94%
Geisinger	$186	104%
Health Partners Plans (Jefferson Health Plan)	$202	113%
Beacon	$218 - $272	122%
Fidelis	$218	122%
Humana	$218 - $809	122%
United Behavioral Health	$218	122%
UnitedHealthcare	$218 - $657	122%
Wellcare	$224	125%
Aetna	$226 - $657	126%
Magnacare	$320 - $758	179%
Independent Health	$377 - $479	210%
Blue Cross Blue Shield	$545	304%
Multiplan	$758	423%
Ghi/Emblem Health	$809	451%
Statewide Independent Ppo	$890	497%
Affordable First Health	$910	508%

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 $607.
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 UPMC Chautauqua at Wca 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.