CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Penn Presbyterian Medical Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $2,025
  • Cash Discount Price: $6,751
  • vs. Medicare Baseline: 11.30x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Penn Presbyterian Medical Center is $2,025. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,751. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 11.30x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$6,751

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,025

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: $6,751 (3767%)
Insurance Median: $2,025 (1130%)
Cash: $6,751 (3767% of Medicare)
Ins. Median: $2,025 (1130% 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 1130% of the Medicare baseline (a markup of 1030%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $100 - $6,751 56%
Keystone Mercy Health Plan $128 - $6,751 71%
Upmc $149 - $6,751 83%
Pa Medical Assistance $159 89%
Blue Cross Blue Shield $183 - $6,751 102%
Medicare (plans) $183 - $187 102%
Philadelphia Va Medical Center $183 102%
Tricare $184 103%
Ibc $187 104%
Cigna $189 - $335 105%
Geisinger Health Plan $189 - $582 105%
Health Partners $189 - $6,751 105%
Humana $189 - $5,401 105%
Pa Health And Wellness $193 - $303 108%
Penn Life (Living Independently For Elders) $193 108%
Aetna $194 - $6,751 108%
UnitedHealthcare $194 - $6,751 108%
Clover Health Plan $198 110%
Keystone First $204 114%
Us Family Health Plan $212 118%
Gateway Health Plan $227 127%
Elap $261 146%
Claims Watcher $294 - $330 164%
Oscar Health Plan $312 174%
Centivo $330 184%
Elap Services $341 190%
Keystone Hmo Proactive $358 200%
Ibc Commercial Hpn $370 206%
Highmark $386 215%
Penn Global Medicine $486 271%
Horizon Nj Health $1,141 - $1,187 637%
Pgm - Regie De L'Assurance Maladie Quebec $1,553 867%
Preferred Health Care Eliance $1,688 942%
Pgm - Kuwait Defense $2,363 - $3,038 1319%
Devon $2,565 - $3,038 1431%
Qualcare $2,565 1431%
Coventry $2,700 - $3,443 1507%
Pgm - Chop $2,700 1507%
Wissahickon Hospice $2,700 1507%
Healthamerica/Coventry $3,038 - $3,308 1695%
Olympus $3,200 1786%
First Health Global $3,376 1884%
Urn-Cancer Resource Services $3,376 1884%
Health Net $4,051 2261%
Pgm - Royal Embassy Of Saudi Arabia $4,051 2261%
Pgm - Embassy Of Qatar $4,388 2449%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $4,388 2449%
Pgm - Embassy Of The United Emirates/Ipc $4,726 2637%
Devon Health Services Inc $5,401 3014%
Health America/Ccn $5,401 3014%
Intergroup $5,401 3014%
Pgm - Kuwait Health Division $5,401 3014%
Pgm - Kuwait Oil $5,401 3014%
Preferred Care $5,401 3014%
Commercial Other $6,751 3767%
International Pfs $6,751 3767%
Magellan $6,751 3767%
Quest Behavioral Health $6,751 3767%
United Behavioral Health $6,751 3767%
Workers Compensation $6,751 3767%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals