CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $2,179
Cash Discount Price: $4,416
vs. Medicare Baseline: 12.16x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Cook Childrens Medical Center Prosper is $2,179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,416. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 12.16x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$4,416

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,179

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: $4,416 (2464%)

Insurance Median: $2,179 (1216%)

Cash: $4,416 (2464% of Medicare)

Ins. Median: $2,179 (1216% 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 1216% of the Medicare baseline (a markup of 1116%). 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	$199 - $5,005	111%
Beacon	$227 - $3,180	127%
El Paso Health First	$227 - $3,180	127%
Health Plan W. Uhrip	$227	127%
Health Plan W/O Uhrip	$227 - $3,180	127%
Tx Children Health	$227 - $3,180	127%
Wellpoint	$239	133%
Blue Cross Blue Shield	$245 - $5,299	137%
Superior Health	$245	137%
Firstcare	$250 - $4,711	140%
United Community	$250 - $2,179	140%
UnitedHealthcare	$2,591 - $5,005	1446%
S&W Health	$4,946	2760%
Cigna	$5,005	2793%
Healthscope	$5,005	2793%
Imagine Health	$5,005	2793%
Humana	$5,123 - $5,182	2859%
Multiplan	$5,123	2859%
First Health	$5,182	2892%
Galaxy Health	$5,299	2957%
Healthsmart	$5,299	2957%
Usamco	$5,417	3023%

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 $4,416.
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 Cook Childrens Medical Center Prosper 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.