CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Mercy

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,924
Cash Discount Price: $3,395
vs. Medicare Baseline: 10.74x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Mercy is $1,924. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,395. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 10.74x the Medicare baseline. Located in 1400 Locust Street, Pittsburgh, PA.

Cash / Self-Pay

$3,395

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,924

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: $3,395 (1895%)

Insurance Median: $1,924 (1074%)

Cash: $3,395 (1895% of Medicare)

Ins. Median: $1,924 (1074% 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 1074% of the Medicare baseline (a markup of 974%). 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
Upmc Health Plan	$141 - $1,191	79%
Aetna	$178 - $2,263	99%
Amerihealth Caritas	$183 - $252	102%
Highmark Wholecare (Prev Gateway)	$183 - $236	102%
Pa Health & Wellness	$183 - $271	102%
UnitedHealthcare	$183	102%
Blue Cross Blue Shield	$379 - $2,159	211%
Upmc Work Partners	$837	467%
Bravo	$1,414	789%
Cigna	$1,924 - $3,395	1074%
Coventry/First Health	$2,490	1390%
Intergroup	$2,829 - $4,526	1579%
Private Health Care Systems	$4,244	2368%
American Healthcare Group	$4,526	2526%
National Provider Network	$4,640	2589%
Health Payors Organization	$5,092	2842%
Multiplan	$5,092	2842%

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 $3,395.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Mercy is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.