CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC St Margaret

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,257
Cash Discount Price: $2,723
vs. Medicare Baseline: 7.01x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC St Margaret is $1,257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,723. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.01x the Medicare baseline. Located in 815 Freeport Road, Pittsburgh, PA.

Cash / Self-Pay

$2,723

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,257

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: $2,723 (1520%)

Insurance Median: $1,257 (701%)

Cash: $2,723 (1520% of Medicare)

Ins. Median: $1,257 (701% 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 701% of the Medicare baseline (a markup of 601%). 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
UnitedHealthcare	$147	82%
Upmc Health Plan	$147 - $275	82%
Aetna	$178 - $1,815	99%
Highmark Wholecare (Prev Gateway)	$183 - $2,269	102%
Pa Health & Wellness	$183 - $228	102%
Amerihealth Caritas	$209	117%
Blue Cross Blue Shield	$314 - $1,872	175%
Upmc Work Partners	$675	377%
Cigna	$1,271 - $1,815	709%
Coventry/First Health	$3,177	1773%
Private Health Care Systems	$3,630	2026%
Selectcare	$3,630	2026%
Humana	$3,857	2152%

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 $2,723.
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 St Margaret 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.