CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Nationwide Children's Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $656
Cash Discount Price: $1,251
vs. Medicare Baseline: 3.66x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Nationwide Children's Hospital is $656. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,251. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.66x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$1,251

Average discount available for prompt cash payment at this facility.

Insurance Median

$656

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: $1,251 (698%)

Insurance Median: $656 (366%)

Cash: $1,251 (698% of Medicare)

Ins. Median: $656 (366% 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 366% of the Medicare baseline (a markup of 266%). 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
Aetna	$60 - $1,320	33%
Caresource	$76 - $605	42%
Humana	$122 - $1,320	68%
UnitedHealthcare	$150 - $1,320	84%
Ohio Ppo Connect	$151 - $1,293	84%
Osu	$151 - $1,293	84%
Blue Cross Blue Shield	$167 - $1,307	93%
Tricare	$187	104%
Mmo	$192 - $1,307	107%
Cigna	$200 - $1,307	112%
Front Path Health Coalition	$200 - $1,307	112%
Ohc	$200 - $1,293	112%
Ohg	$200 - $1,251	112%
The Health Plan	$200 - $1,334	112%
Amerihealth	$605	338%
Bchp	$605	338%
Molina	$605	338%
Ahpo	$1,307	729%
Unicare	$1,320	737%
Emerald Health	$1,362	760%
First Health	$1,362	760%
Phcs	$1,362	760%

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 $1,251.
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 Nationwide Children's 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.