CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Children's Hospital of Philadelphia

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,740
Cash Discount Price: $4,753
vs. Medicare Baseline: 9.71x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Children's Hospital of Philadelphia is $1,740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,753. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.71x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$4,753

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,740

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: $4,753 (2652%)

Insurance Median: $1,740 (971%)

Cash: $4,753 (2652% of Medicare)

Ins. Median: $1,740 (971% 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 971% of the Medicare baseline (a markup of 871%). 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
Geisinger Medical Assistance	$135	75%
Highmark Wholecare	$150	84%
Horizon Nj Health	$620	346%
Medicaid / KanCare	$784	438%
UnitedHealthcare	$789 - $1,299	440%
Health Partners	$896	500%
Aetna	$1,251 - $2,377	698%
Upmc Medical Assistance	$1,298	724%
Keystone First Chip	$1,474	823%
Keystone Health Plan East	$1,503	839%
Blue Cross Blue Shield	$1,678 - $1,904	936%
Geisinger Health Plan Commercial	$1,802	1006%
Jefferson Health Plans	$2,248	1254%
Cigna	$2,377	1326%
Highmark	$2,377	1326%
Qualcare	$2,614	1459%
First Health Network	$3,090	1724%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$3,803	2122%
Private Health Care Systems	$3,803	2122%
Choice Care Network	$4,278	2387%

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 $4,753.
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 Children's Hospital of Philadelphia 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.