CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Kenmore Mercy Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $78
Cash Discount Price: $247
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Kenmore Mercy Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.73x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$247

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $247 (231%)

Insurance Median: $78 (73%)

Cash: $247 (231% of Medicare)

Ins. Median: $78 (73% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

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
UnitedHealthcare	$27 - $148	25%
Medicaid / KanCare	$32 - $127	30%
VA Veterans Affairs [700001]	$33 - $88	31%
Univera Healthcare [100169]	$34 - $129	32%
Univera Healthcare Essential [100170]	$34 - $145	32%
Beacon Essential [350122]	$35 - $125	33%
Vna Option Mltc [350110]	$35 - $127	33%
Excellus Rochester McD [350117]	$35 - $127	33%
Independent Health Essential [100166]	$35 - $145	33%
Tuscarora Nation [550120]	$35 - $127	33%
Crime Victims [100176]	$35 - $127	33%
Ghi [100153]	$37 - $99	35%
Medicare (plans)	$38 - $175	36%
Catholic Health Life Pace [400005]	$39 - $104	37%
Cigna	$39 - $151	37%
Fallon Health [450115]	$39 - $104	37%
Seneca Nation [450119]	$39 - $104	37%
Champ VA [700002]	$39 - $104	37%
Covid19 Hrsa [45013]	$39 - $104	37%
Tricare	$39 - $104	37%
Hospice [550001]	$39 - $104	37%
Fidelis Dual Advantage [450120]	$41 - $109	38%
Aetna	$41 - $109	38%
Wellcare Fidelis Dual [450451]	$41 - $109	38%
Humana	$41 - $109	38%
Independent Health [100165]	$42 - $290	39%
Iha First Choice [800001]	$42 - $292	39%
Fidelis Essential [100163]	$43 - $273	40%
Wellcare [450129]	$43 - $114	40%
Blue Cross Blue Shield	$44 - $273	41%
Beacon Health Options [100023]	$46 - $125	43%
Fidelis Exchange [100164]	$46 - $125	43%
Mvp Healthcare [100168]	$53 - $140	50%
Amerigroup [350102]	$62 - $162	58%
UPMC Health Plan [100181]	$70 - $187	66%
Molina Essential [100167]	$79 - $286	74%
No Fault [114001]	$101 - $403	95%
Federal Workers Compensation [500100]	$101 - $403	95%

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 $247.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kenmore Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.