CMS Price Transparency Data

CT scan, head (no contrast)

Facility: UPMC Horizon

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $919
Cash Discount Price: $1,448
vs. Medicare Baseline: 8.60x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at UPMC Horizon is $919. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,448. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.60x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$1,448

Average discount available for prompt cash payment at this facility.

Insurance Median

$919

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,448 (1356%)

Insurance Median: $919 (860%)

Cash: $1,448 (1356% of Medicare)

Ins. Median: $919 (860% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 860% of the Medicare baseline (a markup of 760%). 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 Health Plan	$91 - $821	85%
Aetna	$104 - $1,448	97%
UnitedHealthcare	$106 - $965	99%
Amerihealth Caritas	$109 - $182	102%
Cigna	$109 - $965	102%
Highmark Wholecare (Prev Gateway)	$109 - $173	102%
Pa Health & Wellness	$109 - $199	102%
Geisinger	$162	152%
Health Partners Plans (Jefferson Health Plan)	$176	165%
Blue Cross Blue Shield	$190 - $1,100	178%
Upmc Work Partners	$539	505%
Intergroup	$1,568	1468%
Coventry/First Health	$1,593	1491%
Health Coalition Partners	$1,689	1581%
Private Health Care Systems	$1,930	1807%
Prime Net	$1,979	1853%
Humana	$2,051	1920%

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 $1,448.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Horizon is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.