CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Clarion Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $385
Cash Discount Price: $840
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Clarion Hospital is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $840. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.15x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.

Cash / Self-Pay

$840

Average discount available for prompt cash payment at this facility.

Insurance Median

$385

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: $840 (469%)

Insurance Median: $385 (215%)

Cash: $840 (469% of Medicare)

Ins. Median: $385 (215% 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 215% of the Medicare baseline (a markup of 115%). 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	$125 - $936	70%
Medicaid / KanCare	$159	89%
Highmark	$170 - $510	95%
Amerihealth	$171 - $175	95%
Cigna	$171 - $750	95%
Highmark Community Blue	$171	95%
Martin'S Point - Usfhp	$171 - $525	95%
Medicare (plans)	$171	95%
Tricare	$171	95%
UnitedHealthcare	$171	95%
Jefferson Health Plan	$175	98%
Aetna	$176 - $1,335	98%
Geisinger	$180 - $191	100%
Devoted Health Plan	$182 - $600	102%
The Health Plan	$182 - $402	102%
Gateway	$183 - $555	102%
Pa Health & Wellness	$183	102%
American Health Plan	$188	105%
Highmark - Ind.& Managed Care	$385 - $510	215%
Peak Health	$402 - $1,050	224%
Workers Comp	$783	437%
Devon	$1,125	628%

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 $840.
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 Clarion Hospital 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.