CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Horizon

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,354
Cash Discount Price: $2,132
vs. Medicare Baseline: 7.56x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Horizon is $1,354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,132. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.56x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$2,132

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,354

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: $2,132 (1190%)

Insurance Median: $1,354 (756%)

Cash: $2,132 (1190% of Medicare)

Ins. Median: $1,354 (756% 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 756% of the Medicare baseline (a markup of 656%). 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	$152 - $1,191	85%
Aetna	$175 - $2,132	98%
UnitedHealthcare	$178 - $1,421	99%
Amerihealth Caritas	$183 - $248	102%
Cigna	$183 - $1,421	102%
Highmark Wholecare (Prev Gateway)	$183 - $236	102%
Pa Health & Wellness	$183 - $271	102%
Geisinger	$221	123%
Health Partners Plans (Jefferson Health Plan)	$240	134%
Blue Cross Blue Shield	$318 - $1,620	177%
Upmc Work Partners	$764	426%
Intergroup	$2,309	1289%
Coventry/First Health	$2,345	1309%
Health Coalition Partners	$2,487	1388%
Private Health Care Systems	$2,842	1586%
Prime Net	$2,913	1626%
Humana	$3,020	1685%

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 $2,132.
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 Horizon 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.