CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC Hamot

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $782
Cash Discount Price: $3,127
vs. Medicare Baseline: 4.36x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC Hamot is $782. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,127. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.36x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$3,127

Average discount available for prompt cash payment at this facility.

Insurance Median

$782

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: $3,127 (1745%)

Insurance Median: $782 (436%)

Cash: $3,127 (1745% of Medicare)

Ins. Median: $782 (436% 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 436% of the Medicare baseline (a markup of 336%). 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
Blue Cross Blue Shield	$131 - $1,504	73%
Upmc Health Plan	$147 - $494	82%
UnitedHealthcare	$154 - $693	86%
Aetna	$161 - $3,648	90%
Geisinger	$186	104%
Fidelis	$196	109%
Highmark Wholecare (Prev Gateway)	$199 - $2,606	111%
Health Partners Plans (Jefferson Health Plan)	$202	113%
Wellcare	$202	113%
Amerihealth Caritas	$209 - $212	117%
Cigna	$212 - $2,085	118%
Pa Health & Wellness	$212 - $228	118%
Independent Health	$271 - $360	151%
Upmc Work Partners	$675	377%
Univera	$782 - $2,293	436%
Intergroup	$3,388 - $4,170	1891%
Multiplan	$3,648 - $4,170	2036%

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 $3,127.
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 Hamot 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.