CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Harlem Hospital Center

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $453
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4.24x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Harlem Hospital Center is $453. 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 $106.81, this hospital’s rate is 4.24x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Insurance Median: $453 (424%)

Ins. Median: $453 (424% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 424% of the Medicare baseline (a markup of 324%). 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	$34 - $1,018	32%
Aetna	$43 - $1,131	40%
Amidacare	$43 - $453	40%
Emblem	$43 - $1,066	40%
Wellcare	$47 - $800	44%
Metroplus	$55 - $1,018	51%
Fidelis	$62 - $1,018	58%
Oscar	$65 - $1,228	61%
Blue Cross Blue Shield	$126 - $1,066	118%
Elderplan	$126 - $866	118%
Vaccn	$126	118%
Vnsny	$126 - $1,133	118%
Centers Plan For Healthy Living	$131	123%
Oxford	$292 - $800	273%
United	$292 - $1,066	273%
Carelon	$453 - $866	424%
Senior Whole Health	$453	424%
United Behavioral Health	$453 - $498	424%
Affinity	$462 - $1,018	433%
Carelon (Amida Care)	$462	433%
Centerlight	$666	624%
Magnacare	$1,000	936%
Cigna	$1,056	989%
Multiplan	$1,066	998%
Local 1199	$1,133	1061%
Villagecare Max	$1,133	1061%

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: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harlem Hospital Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.