CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC Somerset

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $313
Cash Discount Price: $1,295
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC Somerset is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,295. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.75x the Medicare baseline. Located in 225 South Center Avenue, Somerset, PA.

Cash / Self-Pay

$1,295

Average discount available for prompt cash payment at this facility.

Insurance Median

$313

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: $1,295 (723%)

Insurance Median: $313 (175%)

Cash: $1,295 (723% of Medicare)

Ins. Median: $313 (175% 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
UnitedHealthcare	$92 - $930	51%
Upmc Health Plan	$147 - $990	82%
Amerihealth Caritas	$154 - $170	86%
Blue Cross Blue Shield	$168 - $319	94%
Highmark Wholecare (Prev Gateway)	$172 - $183	96%
Geisinger	$186 - $850	104%
Upmc Work Partners	$618	345%
Aetna	$863	482%
Multiplan	$1,079 - $1,403	602%
Galaxy Health Plan	$1,403	783%
Humana	$1,618	903%

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 $1,295.
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 UPMC Somerset 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.