CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Hamot

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $900
  • Cash Discount Price: $3,598
  • vs. Medicare Baseline: 5.02x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Hamot is $900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,598. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.02x the Medicare baseline. Located in 201 State Street, Erie, PA.
Cash / Self-Pay
$3,598

Average discount available for prompt cash payment at this facility.

Insurance Median
$900

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: $3,598 (2008%)
Insurance Median: $900 (502%)
Cash: $3,598 (2008% of Medicare)
Ins. Median: $900 (502% 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 502% of the Medicare baseline (a markup of 402%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $146 - $1,834 81%
Upmc Health Plan $175 - $595 98%
UnitedHealthcare $183 - $693 102%
Aetna $191 - $4,198 107%
Fidelis $196 109%
Wellcare $202 113%
Amerihealth Caritas $212 - $248 118%
Cigna $212 - $2,399 118%
Highmark Wholecare (Prev Gateway) $212 - $2,998 118%
Pa Health & Wellness $212 - $271 118%
Geisinger $221 123%
Health Partners Plans (Jefferson Health Plan) $240 134%
Independent Health $271 - $360 151%
Upmc Work Partners $823 459%
Univera $900 - $2,639 502%
Intergroup $3,898 - $4,798 2175%
Multiplan $4,198 - $4,798 2343%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals