CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Mercyone Clinton Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $406
  • Cash Discount Price: $2,064
  • vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Mercyone Clinton Medical Center is $406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,064. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.27x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$2,064

Average discount available for prompt cash payment at this facility.

Insurance Median
$406

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: $2,064 (1152%)
Insurance Median: $406 (227%)
Cash: $2,064 (1152% of Medicare)
Ins. Median: $406 (227% 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 227% of the Medicare baseline (a markup of 127%). 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 $162 90%
Medicaid / KanCare $163 - $164 91%
Bcn Domestic $179 100%
Blue Benefit Administrators Of Massachusetts $179 100%
Blue Care Network $179 100%
Blue Cross Blue Shield $179 - $185 100%
Blue Distinction Transplant $179 100%
Blue Shield - Ca $179 100%
Blue Shield - Id (Regence) $179 100%
Blue Shield - Ny Highmark Northeastern $179 100%
Blue Shield - Ny Highmark Western $179 100%
Blue Shield - Pa (Highmark) $179 100%
Blue Shield - Wa (Regence) $179 100%
Kaiser Domestic $179 100%
Pre-Employment $179 100%
Wc Domestic $179 100%
Aetna $183 - $2,778 102%
Medicare (plans) $183 - $190 102%
UnitedHealthcare $187 - $3,175 104%
Amish Hospital Aid $248 138%
Oscar $255 142%
Ambetter / Centene $314 175%
Claimdoc $375 209%
Nova $375 209%
Geha $406 227%
Health Choices $899 502%
Medical Associates $899 502%
Preferred Health Choice $918 512%
The Alliance $1,926 1075%
1199 National Benefit Fund $2,778 1550%
Allied Benefit Systems $2,778 1550%
Asr Health Benefits $2,778 1550%
Christian Brother Services $2,778 1550%
Coventry $2,778 1550%
First Health $2,778 1550%
Lucent Health $2,778 1550%
Luminare Health $2,778 1550%
Medical Mutual $2,778 1550%
Meritain $2,778 1550%
Trustmark Small Business Benefits $2,778 1550%
Webtpa $2,778 1550%
Health Partners $2,784 1554%
Auxiant $2,858 1595%
Cigna $2,858 1595%
Medica $2,858 1595%
Midlands $2,858 1595%
Midlands Choice $2,858 1595%
Multiplan $2,858 1595%
Qualcare $2,858 1595%
Usa Managed Care $3,016 1683%
Crime Victim Assistance $3,175 1772%
Iowa Dept Of Public Health $3,175 1772%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals