CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Kane

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $491
  • Cash Discount Price: $681
  • vs. Medicare Baseline: 2.74x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Kane is $491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $681. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.74x the Medicare baseline. Located in 4372 Route 6, Kane, PA.
Cash / Self-Pay
$681

Average discount available for prompt cash payment at this facility.

Insurance Median
$491

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: $681 (380%)
Insurance Median: $491 (274%)
Cash: $681 (380% of Medicare)
Ins. Median: $491 (274% 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 274% of the Medicare baseline (a markup of 174%). 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
UPMC Health Plan $124 - $877 69%
Blue Cross Blue Shield $131 - $709 73%
Highmark Wholecare (Prev Gateway) $134 - $729 75%
Aetna $136 - $738 76%
UnitedHealthcare $137 - $780 76%
Amerihealth Caritas $141 - $766 79%
Geisinger $221 123%
Horizon Health Plan $247 - $1,342 138%
Cigna $247 - $43,156 138%
Multiplan $265 - $1,438 148%
PA Health & Wellness $271 151%
Intergroup $282 - $1,534 157%
Health Coalition Partners $282 - $1,534 157%
Focus Healthcare $335 - $1,821 187%
UPMC Work Partners $752 420%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4372 Route 6, Kane, PA 16735
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals