CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: St Luke's Hospital - Carbon Campus

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $363
  • Cash Discount Price: $5,740
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at St Luke's Hospital - Carbon Campus is $363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,740. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.03x the Medicare baseline. Located in 500 St Luke's Drive, Lehighton, PA.
Cash / Self-Pay
$5,740

Average discount available for prompt cash payment at this facility.

Insurance Median
$363

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: $5,740 (3203%)
Insurance Median: $363 (203%)
Cash: $5,740 (3203% of Medicare)
Ins. Median: $363 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Blue Cross Blue Shield $177 - $1,934 99%
Highmark $177 - $498 99%
Aetna $181 - $2,414 101%
Geisinger $181 - $1,945 101%
Highmark Wholecare $183 102%
Humana $184 103%
Upmc Health Plan $186 - $1,896 104%
Amerihealth Caritas $191 107%
UnitedHealthcare $191 - $1,999 107%
Jefferson Health Plan $229 128%
Oscar $1,795 1002%
Cigna $1,893 1056%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 St Luke's Drive, Lehighton, PA 18235
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals