CMS Price Transparency Data

CT scan, sinuses

Facility: Decatur County Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,137
  • Cash Discount Price: $1,137
  • vs. Medicare Baseline: 10.65x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Decatur County Hospital is $1,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,137. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.65x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$1,137

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,137

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: $1,137 (1065%)
Insurance Median: $1,137 (1065%)
Cash: $1,137 (1065% of Medicare)
Ins. Median: $1,137 (1065% 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 1065% of the Medicare baseline (a markup of 965%). 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
Blue Cross Blue Shield $455 426%
Wellmark Hmo $480 449%
Wellmark Ppo - All Other Plans $529 495%
Champva -All Plans $639 598%
Everystep Hospice-All Plans $739 692%
Aetna $767 - $1,123 718%
Tricare $767 718%
UnitedHealthcare $853 - $1,208 799%
Benefit Admin System-All Plans $924 865%
Humana $1,037 971%
Meritain Health-All Plans $1,037 971%
Misc Commercial-All Plans $1,037 971%
All Savers-All Plans $1,066 998%
Allied Benefit System-All Plans $1,066 998%
American Family Ins Grp-All Plans $1,066 998%
Rural Carrier Benefit Plan-All Plans $1,094 1024%
Christian Healthcare -All Plans $1,137 1065%
Medica-All Other Plans $1,137 1065%
Golden Rule-All Plans $1,208 1131%
Ntca The Rural Broadband-All Plans $1,208 1131%
Cigna $1,222 1144%
Medical Mutual-All Plans $1,250 1170%
Farm Bureau Financial-All Other Plans $1,279 1197%
Farm Bureau Property And Ca $1,279 1197%
Medi Share-All Plans $1,293 1211%
Uhss-All Plans $1,293 1211%
Health Partners-All Plans $1,307 1224%
Lewermark-All Plans $1,350 1264%
Mail Handlers Benefit-All Plans $1,393 1304%
Midlands Choice-All Plans $1,393 1304%
Priority Health-All Plans $1,421 1330%
Iowa Total Care Mcaid-All Plans $1,449 1357%
Amerigroup Mcaid-All Plans $1,492 1397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals