CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Harlem Hospital Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $453
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with 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 $179.2, this hospital’s rate is 2.53x 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

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Insurance Median: $453 (253%)

Ins. Median: $453 (253% 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 253% of the Medicare baseline (a markup of 153%). 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	$46 - $1,018	26%
Aetna	$57 - $1,131	32%
Amidacare	$57 - $453	32%
Emblem	$57 - $611	32%
Wellcare	$62 - $181	35%
Metroplus	$74 - $1,018	41%
Fidelis	$82 - $1,018	46%
Oscar	$86 - $1,228	48%
United	$145 - $624	81%
Blue Cross Blue Shield	$211 - $1,018	118%
Vaccn	$211	118%
Vnsny	$211 - $663	118%
Centers Plan For Healthy Living	$219	122%
Centerlight	$390	218%
Oxford	$390 - $468	218%
Elderplan	$421 - $507	235%
Carelon	$453 - $507	253%
Senior Whole Health	$453	253%
United Behavioral Health	$453 - $498	253%
Affinity	$462 - $1,018	258%
Carelon (Amida Care)	$462	258%
Magnacare	$585	326%
Multiplan	$624	348%
Local 1199	$663	370%
Villagecare Max	$663	370%
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: 70460.

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 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.