CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Presbyterian Shadyside

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,995
Cash Discount Price: $5,112
vs. Medicare Baseline: 22.29x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Presbyterian Shadyside is $3,995. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,112. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 22.29x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$5,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,995

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: $5,112 (2853%)

Insurance Median: $3,995 (2229%)

Cash: $5,112 (2853% of Medicare)

Ins. Median: $3,995 (2229% 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 2229% of the Medicare baseline (a markup of 2129%). 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	$120 - $183	67%
Upmc Health Plan	$175 - $3,995	98%
Amerihealth Caritas	$183 - $252	102%
Cigna	$183	102%
Highmark Wholecare (Prev Gateway)	$183 - $4,260	102%
Pa Health & Wellness	$183 - $271	102%
Aetna	$187 - $2,130	104%
Health Partners Plans (Jefferson Health Plan)	$240	134%
Geisinger	$248	138%
Blue Cross Blue Shield	$383 - $2,543	214%
Upmc Work Partners	$837	467%
Multiplan	$974 - $6,816	544%
Preferred Healthcare System	$5,538	3090%
Coventry/First Health	$5,964	3328%
Fidelis	$6,390	3566%
Intergroup	$6,390 - $7,242	3566%
Health Coalition Partners	$6,816	3804%
Private Health Care Systems	$6,816	3804%
Selectcare	$6,816	3804%
Health Payors Organization	$7,242	4041%
Humana	$7,242	4041%

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 $5,112.
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 UPMC Presbyterian Shadyside 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.