CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Mercy Hospital of Buffalo

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $113
  • Cash Discount Price: $287
  • vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Mercy Hospital of Buffalo is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 0.63x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$287

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $287 (160%)
Insurance Median: $113 (63%)
Cash: $287 (160% of Medicare)
Ins. Median: $113 (63% 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.

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
UnitedHealthcare $36 - $179 20%
Medicaid / KanCare $42 - $193 23%
VA Veterans Affairs [700001] $44 - $145 25%
Univera Healthcare [100169] $45 - $179 25%
Univera Healthcare Essential [100170] $45 - $176 25%
Independent Health Essential [100166] $47 - $231 26%
Vna Option Mltc [350110] $47 - $166 26%
Crime Victims [100176] $47 - $166 26%
Beacon Essential [350122] $47 - $175 26%
Tuscarora Nation [550120] $47 - $166 26%
Fidelis Essential [100163] $47 - $330 26%
Blue Cross Blue Shield $47 - $330 26%
Amerigroup [350102] $47 - $226 26%
Excellus Rochester McD [350117] $47 - $166 26%
Ghi [100153] $49 - $138 27%
Medicare (plans) $51 - $279 28%
Meritain [100063] $52 - $145 29%
Seneca Nation [450119] $52 - $145 29%
Champ VA [700002] $52 - $145 29%
Fallon Health [450115] $52 - $145 29%
Covid19 Hrsa [45013] $52 - $145 29%
Cigna $52 - $211 29%
Aetna $52 - $153 29%
Catholic Health Life Pace [400005] $52 - $145 29%
Hospice [550001] $52 - $145 29%
Magnacare [100142] $52 - $145 29%
Humana $52 - $153 29%
Tricare $52 - $145 29%
Fidelis Dual Advantage [450120] $54 - $153 30%
Wellcare Fidelis Dual [450451] $54 - $153 30%
Independent Health [100165] $56 - $463 31%
Iha First Choice [800001] $56 - $606 31%
Wellcare [450129] $57 - $160 32%
UPMC Health Plan [100181] $60 - $278 33%
Beacon Health Options [100023] $62 - $175 35%
Fidelis Exchange [100164] $62 - $175 35%
Mvp Healthcare [100168] $70 - $198 39%
Molina Essential [100167] $106 - $373 59%
No Fault [114001] $116 - $463 65%
Federal Workers Compensation [500100] $116 - $463 65%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals