CMS Price Transparency Data

CT scan, sinuses

Facility: Mercyone Oelwein Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,803
  • Cash Discount Price: $1,275
  • vs. Medicare Baseline: 16.88x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercyone Oelwein Medical Center is $1,803. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,275. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.88x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$1,275

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,803

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: $1,275 (1194%)
Insurance Median: $1,803 (1688%)
Cash: $1,275 (1194% of Medicare)
Ins. Median: $1,803 (1688% 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 1688% of the Medicare baseline (a markup of 1588%). 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
Medicare (plans) $750 - $836 702%
Iowa Total Care $760 712%
Medicaid / KanCare $772 - $775 723%
Blue Cross Blue Shield $796 745%
UnitedHealthcare $853 - $1,393 799%
Aetna $925 - $1,803 866%
Amish Hospital Aid $1,070 1002%
Centivo $1,207 1130%
Ambetter / Centene $1,351 1265%
Geha $1,393 1304%
Health Choices $1,444 1352%
Medical Associates $1,444 1352%
Claimdoc $1,617 1514%
Nova $1,617 1514%
1199 National Benefit Fund $1,803 1688%
Allied Benefit Systems $1,803 1688%
Asr Health Benefits $1,803 1688%
Christian Brother Services $1,803 1688%
Coventry $1,803 1688%
First Health $1,803 1688%
Lucent Health $1,803 1688%
Luminare Health $1,803 1688%
Medical Mutual $1,803 1688%
Meritain $1,803 1688%
Trustmark Small Business Benefits $1,803 1688%
Webtpa $1,803 1688%
Health Partners $1,887 1767%
Multiplan $1,903 1782%
Auxiant $1,923 1800%
Cigna $1,923 1800%
Medica $1,923 1800%
Midlands $1,923 1800%
Midlands Choice $1,923 1800%
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: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals