CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Pennsylvania Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,975
  • Cash Discount Price: $7,597
  • vs. Medicare Baseline: 11.02x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Pennsylvania Hospital is $1,975. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,597. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 11.02x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$7,597

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,975

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: $7,597 (4239%)
Insurance Median: $1,975 (1102%)
Cash: $7,597 (4239% of Medicare)
Ins. Median: $1,975 (1102% 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 1102% of the Medicare baseline (a markup of 1002%). 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
Gateway Health Plan $80 - $227 45%
Medicaid / KanCare $80 - $7,597 45%
Keystone Mercy Health Plan $102 57%
Upmc $119 - $7,597 66%
Pa Medical Assistance $134 75%
UnitedHealthcare $158 - $7,597 88%
Health Partners $180 - $7,597 100%
Blue Cross Blue Shield $183 - $7,597 102%
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 - $6,078 105%
Pa Health And Wellness $193 - $303 108%
Penn Life (Living Independently For Elders) $193 108%
Aetna $194 - $7,597 108%
Clover Health Plan $198 110%
Keystone First $204 114%
Us Family Health Plan $212 118%
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 $1,284 - $1,336 717%
Pgm - Regie De L'Assurance Maladie Quebec $1,747 975%
Preferred Health Care Eliance $1,975 1102%
Pgm - Kuwait Defense $2,659 - $3,419 1484%
Devon $2,887 - $3,419 1611%
Qualcare $2,887 1611%
Coventry $3,039 - $3,874 1696%
Pgm - Chop $3,039 1696%
Wissahickon Hospice $3,039 1696%
Healthamerica/Coventry $3,419 - $3,723 1908%
Olympus $3,692 2060%
First Health Global $3,798 2119%
Urn-Cancer Resource Services $3,798 2119%
Health Net $4,558 2544%
Pgm - Royal Embassy Of Saudi Arabia $4,558 2544%
Pgm - Embassy Of Qatar $4,938 2756%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $4,938 2756%
Pgm - Embassy Of The United Emirates/Ipc $5,318 2968%
Devon Health Services Inc $6,078 3392%
Health America/Ccn $6,078 3392%
Intergroup $6,078 3392%
Pgm - Kuwait Health Division $6,078 3392%
Pgm - Kuwait Oil $6,078 3392%
Preferred Care $6,078 3392%
Commercial Other $7,597 4239%
Community Behavioral Health $7,597 4239%
International Pfs $7,597 4239%
Quest Behavioral Health $7,597 4239%
United Behavioral Health $7,597 4239%
Workers Compensation $7,597 4239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals