CMS Price Transparency Data

CT scan, sinuses

Facility: Mercyone Newton Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $122
  • Cash Discount Price: $1,619
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercyone Newton Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,619. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$1,619

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $1,619 (1516%)
Insurance Median: $122 (114%)
Cash: $1,619 (1516% of Medicare)
Ins. Median: $122 (114% 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.

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 $99 - $1,838 93%
Medicare (plans) $99 - $103 93%
Blue Cross Blue Shield $100 - $107 94%
UnitedHealthcare $101 - $1,118 95%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Iowa Total Care $121 113%
Medicaid / KanCare $122 114%
Amish Hospital Aid $134 125%
Oscar $143 134%
Centivo $146 137%
Ambetter / Centene $170 159%
Claimdoc $203 190%
Nova $203 190%
Geha $1,118 1047%
Newton Correctional Facility $1,275 1194%
Health Choices $1,481 1387%
Medical Associates $1,481 1387%
Health Partners $1,730 1620%
Auxiant $1,805 1690%
Cigna $1,805 1690%
Health Alliance $1,805 1690%
Medica $1,805 1690%
Midlands $1,805 1690%
Midlands Choice $1,805 1690%
1199 National Benefit Fund $1,838 1721%
Allied Benefit Systems $1,838 1721%
Asr Health Benefits $1,838 1721%
Christian Brother Services $1,838 1721%
Coventry $1,838 1721%
First Health $1,838 1721%
Lucent Health $1,838 1721%
Luminare Health $1,838 1721%
Medical Mutual $1,838 1721%
Meritain $1,838 1721%
Trustmark Small Business Benefits $1,838 1721%
Webtpa $1,838 1721%
Crime Victim Assistance $1,962 1837%
Iowa Dept Of Public Health $1,962 1837%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals