CMS Price Transparency Data

CT scan, sinuses

Facility: Mercyone Dubuque Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,637
  • Cash Discount Price: $1,282
  • vs. Medicare Baseline: 15.33x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercyone Dubuque Medical Center is $1,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,282. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.33x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$1,282

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,637

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: $1,282 (1200%)
Insurance Median: $1,637 (1533%)
Cash: $1,282 (1200% of Medicare)
Ins. Median: $1,637 (1533% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1533% of the Medicare baseline (a markup of 1433%). 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
Iowa Total Care $94 88%
Medicaid / KanCare $95 89%
Aetna $102 - $1,647 95%
Medicare (plans) $102 - $106 95%
Blue Cross Blue Shield $103 96%
UnitedHealthcare $104 - $1,972 97%
Amish Hospital Aid $138 129%
Oscar $142 133%
Centivo $163 153%
Ambetter / Centene $175 164%
Claimdoc $209 196%
Nova $209 196%
Geha $240 225%
Preferred Health Choice $704 659%
Health Choices $722 676%
Midlands Choice $1,144 - $1,775 1071%
Wps $1,181 1106%
The Alliance $1,191 1115%
Mhnet $1,578 1477%
1199 National Benefit Fund $1,647 1542%
Allied Benefit Systems $1,647 1542%
Asr Health Benefits $1,647 1542%
Christian Brother Services $1,647 1542%
Coventry $1,647 1542%
First Health $1,647 1542%
Lucent Health $1,647 1542%
Luminare Health $1,647 1542%
Medical Mutual $1,647 1542%
Meritain $1,647 1542%
Trustmark Small Business Benefits $1,647 1542%
Webtpa $1,647 1542%
Auxiant $1,775 1662%
Cigna $1,775 1662%
Medica $1,775 1662%
Midlands $1,775 1662%
Multiplan $1,775 1662%
Unity $1,775 1662%
Crime Victim Assistance $1,972 1846%
Iowa Dept Of Public Health $1,972 1846%
Stephenson Cty Health $1,972 1846%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals