CMS Price Transparency Data

CT scan, head (with contrast)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $2,274
Cash Discount Price: $2,903
vs. Medicare Baseline: 12.69x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at UPMC Children's Hospital of Pittsburgh is $2,274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,903. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 12.69x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$2,903

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,274

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: $2,903 (1620%)

Insurance Median: $2,274 (1269%)

Cash: $2,903 (1620% of Medicare)

Ins. Median: $2,274 (1269% 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 1269% of the Medicare baseline (a markup of 1169%). 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
Aetna	$159 - $2,661	89%
Health Plan Of Upper Ohio Valley	$170 - $3,145	95%
Blue Cross Blue Shield	$180 - $2,420	100%
Amerihealth Caritas	$183 - $502	102%
Cigna	$183 - $2,661	102%
Upmc Health Plan	$309 - $1,228	172%
UnitedHealthcare	$318 - $2,274	177%
Health Partners Plans (Jefferson Health Plan)	$519	290%
Highmark Wholecare (Prev Gateway)	$541	302%
Pa Health & Wellness	$543	303%
Geisinger	$551 - $2,175	307%
Intergroup	$3,145 - $4,113	1755%
Coventry/First Health	$3,871	2160%
Saudi Armed Forces	$3,871	2160%
Health Payors Organization	$4,113	2295%
Multiplan	$4,113	2295%
National Provider Network	$4,355	2430%
Private Health Care Systems	$4,355	2430%

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 $2,903.
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 UPMC Children's Hospital of Pittsburgh 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.