CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $2,740
Cash Discount Price: $3,497
vs. Medicare Baseline: 15.29x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at UPMC Children's Hospital of Pittsburgh is $2,740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,497. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 15.29x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$3,497

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,740

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: $3,497 (1951%)

Insurance Median: $2,740 (1529%)

Cash: $3,497 (1951% of Medicare)

Ins. Median: $2,740 (1529% 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 1529% of the Medicare baseline (a markup of 1429%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Plan Of Upper Ohio Valley	$170 - $3,789	95%
Blue Cross Blue Shield	$180 - $2,914	100%
Amerihealth Caritas	$183 - $596	102%
Cigna	$183 - $3,206	102%
Aetna	$186 - $3,206	104%
Upmc Health Plan	$367 - $1,478	205%
UnitedHealthcare	$397 - $2,740	222%
Health Partners Plans (Jefferson Health Plan)	$616	344%
Highmark Wholecare (Prev Gateway)	$642	358%
Pa Health & Wellness	$645	360%
Geisinger	$654 - $2,620	365%
Intergroup	$3,789 - $4,955	2114%
Coventry/First Health	$4,663	2602%
Saudi Armed Forces	$4,663	2602%
Health Payors Organization	$4,955	2765%
Multiplan	$4,955	2765%
National Provider Network	$5,246	2927%
Private Health Care Systems	$5,246	2927%

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 $3,497.
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 UPMC Children's Hospital of Pittsburgh 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.