CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Children's Hospital of Philadelphia

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,766
Cash Discount Price: $4,904
vs. Medicare Baseline: 9.85x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Children's Hospital of Philadelphia is $1,766. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,904. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.85x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$4,904

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,766

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: $4,904 (2737%)

Insurance Median: $1,766 (985%)

Cash: $4,904 (2737% of Medicare)

Ins. Median: $1,766 (985% 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 985% of the Medicare baseline (a markup of 885%). 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	$108	60%
Highmark Wholecare	$120	67%
Horizon Nj Health	$508	283%
Medicaid / KanCare	$809	451%
UnitedHealthcare	$814 - $1,299	454%
Health Partners	$924	516%
Aetna	$1,291 - $2,452	720%
Upmc Medical Assistance	$1,339	747%
Keystone First Chip	$1,520	848%
Keystone Health Plan East	$1,551	866%
Blue Cross Blue Shield	$1,731 - $1,964	966%
Geisinger Health Plan Commercial	$1,802	1006%
Jefferson Health Plans	$2,319	1294%
Cigna	$2,452	1368%
Highmark	$2,452	1368%
Qualcare	$2,697	1505%
First Health Network	$3,187	1778%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$3,923	2189%
Private Health Care Systems	$3,923	2189%
Choice Care Network	$4,413	2463%

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 $4,904.
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 Children's Hospital of Philadelphia 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.