CMS Price Transparency Data

CT scan, head (with contrast)

Facility: St Mary Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $330
Cash Discount Price: $1,767
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at St Mary Medical Center is $330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,767. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 1.84x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$1,767

Average discount available for prompt cash payment at this facility.

Insurance Median

$330

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: $1,767 (986%)

Insurance Median: $330 (184%)

Cash: $1,767 (986% of Medicare)

Ins. Median: $330 (184% 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
UnitedHealthcare	$131 - $1,316	73%
Medicaid / KanCare	$151 - $322	84%
Blue Cross Blue Shield	$189	105%
Cigna	$191 - $1,701	107%
Align Senior Care	$193	108%
Aetna	$194 - $2,419	108%
Medicare (plans)	$194 - $340	108%
Health America Advantra	$227	127%
Pace-Trinity Health	$299	167%
Keystone First	$322	180%
Keystone First Chip	$322	180%
Ambetter / Centene	$338	189%
Oscar	$340	190%
Prime Healthcare	$340	190%
Jefferson Health Plan Commercial	$344	192%
Homestead Health Plans Woods Center	$369	206%
Group Pension Administrators	$425	237%
Reedman Toll	$425	237%
Blue Shield - Pa (Highmark)	$511	285%
Geha	$1,109	619%
Upmc Health Plan	$1,701	949%
Webtpa	$1,701	949%
Meritain	$2,419	1350%
Multiplan	$2,446	1365%
Prime Health Services	$2,446	1365%
Galaxy Health Network	$2,582	1441%
Three Rivers Provider Network	$2,582	1441%

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 $1,767.
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 St Mary Medical Center 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.