CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $643
Cash Discount Price: $478
vs. Medicare Baseline: 3.59x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Wellspan Ephrata Community Hospital is $643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.59x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.

Cash / Self-Pay

$478

Average discount available for prompt cash payment at this facility.

Insurance Median

$643

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: $478 (267%)

Insurance Median: $643 (359%)

Cash: $478 (267% of Medicare)

Ins. Median: $643 (359% 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 359% of the Medicare baseline (a markup of 259%). 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
Medicaid / KanCare	$100 - $301	56%
Medicare (plans)	$174 - $416	97%
Aetna	$177 - $957	99%
Highmark	$267 - $788	149%
Blue_Cross	$407 - $1,521	227%
Wellspan_Capital_Blue_Cross	$438	244%
United_Healthcare	$1,007	562%
First_Health_Network	$1,052	587%
Cigna	$1,275 - $1,507	711%
Geisinger	$1,535	857%
Independence_Blue_Cross	$1,535	857%
Tower Health	$1,535 - $1,618	857%
Upmc	$1,535 - $1,890	857%
Phc	$1,653 - $1,677	922%

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 $478.
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 Wellspan Ephrata Community Hospital 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.