CMS Price Transparency Data

CT scan, head (with contrast)

Facility: O'Connor Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $274
Cash Discount Price: $453
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at O'Connor Hospital is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $453. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.53x the Medicare baseline. Located in 460 Andes Road, Delhi, NY.

Cash / Self-Pay

$453

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $453 (253%)

Insurance Median: $274 (153%)

Cash: $453 (253% of Medicare)

Ins. Median: $274 (153% 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.

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
Blue Cross Blue Shield	$79 - $2,480	44%
Emblem	$87 - $1,054	49%
UnitedHealthcare	$87 - $1,054	49%
Cdphp	$88 - $1,086	49%
Mvp	$88 - $1,086	49%
Aetna	$93 - $2,635	52%
Fidelis	$93 - $1,128	52%
Humana	$94 - $1,138	52%

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 $453.
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 O'Connor Hospital 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.