CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC Presbyterian Shadyside

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $3,595
Cash Discount Price: $4,600
vs. Medicare Baseline: 20.06x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC Presbyterian Shadyside is $3,595. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,600. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 20.06x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$4,600

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,595

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: $4,600 (2567%)

Insurance Median: $3,595 (2006%)

Cash: $4,600 (2567% of Medicare)

Ins. Median: $3,595 (2006% 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 2006% of the Medicare baseline (a markup of 1906%). 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	$96 - $183	54%
Upmc Health Plan	$147 - $3,595	82%
Aetna	$174 - $1,916	97%
Amerihealth Caritas	$183 - $212	102%
Cigna	$183	102%
Highmark Wholecare (Prev Gateway)	$183 - $3,833	102%
Pa Health & Wellness	$183 - $228	102%
Health Partners Plans (Jefferson Health Plan)	$202	113%
Geisinger	$209	117%
Blue Cross Blue Shield	$314 - $2,084	175%
Upmc Work Partners	$687	383%
Multiplan	$799 - $6,133	446%
Preferred Healthcare System	$4,983	2781%
Coventry/First Health	$5,366	2994%
Fidelis	$5,750	3209%
Intergroup	$5,750 - $6,516	3209%
Health Coalition Partners	$6,133	3422%
Private Health Care Systems	$6,133	3422%
Selectcare	$6,133	3422%
Health Payors Organization	$6,516	3636%
Humana	$6,516	3636%

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 $4,600.
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 Presbyterian Shadyside 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.