CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Clarion Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $275
  • Cash Discount Price: $440
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Clarion Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $440. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.53x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$440

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $440 (246%)
Insurance Median: $275 (153%)
Cash: $440 (246% of Medicare)
Ins. Median: $275 (153% 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.

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 $100 - $778 56%
Medicaid / KanCare $134 75%
Amerihealth $147 - $171 82%
Jefferson Health Plan $147 82%
Geisinger $161 - $180 90%
Highmark $170 - $284 95%
Cigna $171 - $392 95%
Highmark Community Blue $171 95%
Martin'S Point - Usfhp $171 - $275 95%
Medicare (plans) $171 95%
Tricare $171 95%
UnitedHealthcare $171 95%
Aetna $176 - $699 98%
Devoted Health Plan $182 - $600 102%
The Health Plan $182 - $402 102%
Gateway $183 - $290 102%
Pa Health & Wellness $183 102%
American Health Plan $188 105%
Highmark - Ind.& Managed Care $267 - $385 149%
Peak Health $402 - $1,050 224%
Devon $589 - $1,125 329%
Workers Comp $642 358%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals