CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Hospital for Special Surgery

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $857
Cash Discount Price: $1,219
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Hospital for Special Surgery is $857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,219. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.78x the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$1,219

Average discount available for prompt cash payment at this facility.

Insurance Median

$857

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: $1,219 (680%)

Insurance Median: $857 (478%)

Cash: $1,219 (680% of Medicare)

Ins. Median: $857 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
UnitedHealthcare	$41 - $1,183	23%
Fidelis	$42 - $45	23%
Metro Plus	$56 - $59	31%
Emblem	$58 - $76	32%
Blue Cross Blue Shield	$78 - $2,063	44%
Nyship	$86	48%
Horizon	$95	53%
Cigna	$119 - $1,560	66%
Aetna	$137 - $857	76%
Fidelis Essential [1323]	$330	184%
Apwu [1016]	$771 - $1,560	430%
Nalc [1090]	$771 - $1,560	430%
Qualcare [1101]	$771 - $1,560	430%
Wellfleet [1361]	$771 - $1,560	430%
Oxford [1096]	$823 - $857	459%
Affinity By Molina Health Plan [1005]	$857 - $1,124	478%
Christian Brothers [1034]	$857	478%
Connecticare [1039]	$857 - $1,831	478%
Emblem Health [1043]	$857 - $1,831	478%
Harvard Pilgrim [1057]	$857 - $1,183	478%
Medicare (plans)	$857	478%
Meritain Health [1085]	$857	478%
Nippon Life [1092]	$857	478%
Student Resources [1103]	$857 - $1,030	478%
Webtpa [1356]	$857	478%
Geha [1053]	$1,030	575%

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 $1,219.
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 Hospital for Special Surgery 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.