CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Penn Presbyterian Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,696
  • Cash Discount Price: $5,653
  • vs. Medicare Baseline: 9.46x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Penn Presbyterian Medical Center is $1,696. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,653. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.46x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$5,653

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,696

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: $5,653 (3155%)
Insurance Median: $1,696 (946%)
Cash: $5,653 (3155% of Medicare)
Ins. Median: $1,696 (946% 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 946% of the Medicare baseline (a markup of 846%). 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 $80 - $5,653 45%
Keystone Mercy Health Plan $102 - $5,653 57%
Upmc $119 - $5,653 66%
Pa Medical Assistance $134 75%
UnitedHealthcare $158 - $5,653 88%
Health Partners $180 - $5,653 100%
Blue Cross Blue Shield $183 - $5,653 102%
Medicare (plans) $183 - $187 102%
Philadelphia Va Medical Center $183 102%
Tricare $184 103%
Ibc $187 104%
Cigna $189 - $279 105%
Geisinger Health Plan $189 - $582 105%
Humana $189 - $4,522 105%
Pa Health And Wellness $193 - $303 108%
Penn Life (Living Independently For Elders) $193 108%
Aetna $194 - $5,653 108%
Clover Health Plan $198 110%
Keystone First $204 114%
Us Family Health Plan $212 118%
Gateway Health Plan $227 127%
Elap $261 146%
Keystone Hmo Proactive $292 163%
Claims Watcher $294 - $330 164%
Ibc Commercial Hpn $302 169%
Oscar Health Plan $312 174%
Centivo $330 184%
Elap Services $341 190%
Highmark $386 215%
Penn Global Medicine $486 271%
Horizon Nj Health $955 - $994 533%
Pgm - Regie De L'Assurance Maladie Quebec $1,300 725%
Preferred Health Care Eliance $1,413 789%
Pgm - Kuwait Defense $1,979 - $2,544 1104%
Devon $2,148 - $2,544 1199%
Qualcare $2,148 1199%
Coventry $2,261 - $2,883 1262%
Pgm - Chop $2,261 1262%
Wissahickon Hospice $2,261 1262%
Healthamerica/Coventry $2,544 - $2,770 1420%
Olympus $2,680 1496%
First Health Global $2,826 1577%
Urn-Cancer Resource Services $2,826 1577%
Health Net $3,392 1893%
Pgm - Royal Embassy Of Saudi Arabia $3,392 1893%
Pgm - Embassy Of Qatar $3,674 2050%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $3,674 2050%
Pgm - Embassy Of The United Emirates/Ipc $3,957 2208%
Devon Health Services Inc $4,522 2523%
Health America/Ccn $4,522 2523%
Intergroup $4,522 2523%
Pgm - Kuwait Health Division $4,522 2523%
Pgm - Kuwait Oil $4,522 2523%
Preferred Care $4,522 2523%
Commercial Other $5,653 3155%
International Pfs $5,653 3155%
Magellan $5,653 3155%
Quest Behavioral Health $5,653 3155%
United Behavioral Health $5,653 3155%
Workers Compensation $5,653 3155%

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