CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: St Mary Medical Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $342
Cash Discount Price: $2,170
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Mary Medical Center is $342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,170. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.91x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$2,170

Average discount available for prompt cash payment at this facility.

Insurance Median

$342

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: $2,170 (1211%)

Insurance Median: $342 (191%)

Cash: $2,170 (1211% of Medicare)

Ins. Median: $342 (191% 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.

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	$151 - $382	84%
UnitedHealthcare	$164 - $1,616	92%
Blue Cross Blue Shield	$189	105%
Cigna	$191 - $1,701	107%
Align Senior Care	$193	108%
Medicare (plans)	$194 - $340	108%
Aetna	$200 - $2,972	112%
Health America Advantra	$227	127%
Ambetter / Centene	$338	189%
Oscar	$340	190%
Prime Healthcare	$340	190%
Jefferson Health Plan Commercial	$344	192%
Pace-Trinity Health	$367	205%
Homestead Health Plans Woods Center	$369	206%
Keystone First	$382	213%
Keystone First Chip	$382	213%
Group Pension Administrators	$425	237%
Reedman Toll	$425	237%
Blue Shield - Pa (Highmark)	$511	285%
Geha	$1,362	760%
Upmc Health Plan	$1,701	949%
Webtpa	$1,701	949%
Meritain	$2,972	1658%
Multiplan	$3,005	1677%
Prime Health Services	$3,005	1677%
Galaxy Health Network	$3,172	1770%
Three Rivers Provider Network	$3,172	1770%

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 $2,170.
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 St Mary Medical Center 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.