CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,634
Cash Discount Price: $3,312
vs. Medicare Baseline: 9.12x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Cook Childrens Medical Center Prosper is $1,634. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,312. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.12x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$3,312

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,634

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: $3,312 (1848%)

Insurance Median: $1,634 (912%)

Cash: $3,312 (1848% of Medicare)

Ins. Median: $1,634 (912% 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 912% of the Medicare baseline (a markup of 812%). 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	$170 - $3,754	95%
Beacon	$227 - $2,385	127%
El Paso Health First	$227 - $2,385	127%
Health Plan W. Uhrip	$227	127%
Health Plan W/O Uhrip	$227 - $2,385	127%
Tx Children Health	$227 - $2,385	127%
Wellpoint	$239	133%
Blue Cross Blue Shield	$245 - $3,975	137%
Superior Health	$245	137%
Firstcare	$250 - $3,533	140%
United Community	$250 - $1,634	140%
UnitedHealthcare	$1,943 - $3,754	1084%
S&W Health	$3,710	2070%
Cigna	$3,754	2095%
Healthscope	$3,754	2095%
Imagine Health	$3,754	2095%
Humana	$3,842 - $3,886	2144%
Multiplan	$3,842	2144%
First Health	$3,886	2169%
Galaxy Health	$3,975	2218%
Healthsmart	$3,975	2218%
Usamco	$4,063	2267%

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 $3,312.
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 Cook Childrens Medical Center Prosper 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.