CMS Price Transparency Data

CT scan, head (with contrast)

Facility: St Anthony Community Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $1,402
  • Cash Discount Price: $3,396
  • vs. Medicare Baseline: 7.82x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at St Anthony Community Hospital is $1,402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,396. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 7.82x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$3,396

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,402

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: $3,396 (1895%)
Insurance Median: $1,402 (782%)
Cash: $3,396 (1895% of Medicare)
Ins. Median: $1,402 (782% 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 782% of the Medicare baseline (a markup of 682%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Hamaspik (McR) $218 122%
Medicare (plans) $218 - $233 122%
Mvp Gold (McR) $218 122%
Tricare $219 122%
Affinity By Molina McR $229 128%
Emblem $235 - $448 131%
Emblem Select Care (Exchange) $277 155%
Aetna $298 - $332 166%
Emblem Ghi/Hip PPO $326 182%
Cigna $386 215%
Mvp Exchange $410 229%
Geisinger Health Commercial/Exchange $719 401%
Mvp Hmo/Ppo $798 445%
Self-Pay - Cc 30% $1,019 569%
Blue Cross Blue Shield $1,396 - $8,618 779%
Self-Pay $1,544 862%
Cdphp $1,698 948%
Self-Pay - Cc 50% $1,698 948%
Oxford Commercial $1,931 1078%
Oxford Exchange $2,532 1413%
UnitedHealthcare $2,532 - $2,979 1413%
PHCS $2,547 1421%
Multiplan $2,547 1421%
Emblem Ghi/Hip Hmo/Epo/Pos $2,717 1516%
First Health $2,887 1611%
Magnacare Preferred $3,056 1705%
Mvp $30,451 - $35,889 16993%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals