CMS Price Transparency Data

CT scan, sinuses

Facility: Mercy Rehabilitation Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $4,155
  • Cash Discount Price: $4,155
  • vs. Medicare Baseline: 38.90x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Rehabilitation Hospital is $4,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,155. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 38.90x the Medicare baseline. Located in 1401 Campus Dr, Clive, IA.
Cash / Self-Pay
$4,155

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,155

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: $4,155 (3890%)
Insurance Median: $4,155 (3890%)
Cash: $4,155 (3890% of Medicare)
Ins. Median: $4,155 (3890% 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 3890% of the Medicare baseline (a markup of 3790%). 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
Aetna $4,155 3890%
Medica - Midlands Choice $4,155 3890%
Cigna $4,155 3890%
Consociate Health $4,155 3890%
UnitedHealthcare $4,155 3890%
Blue Cross Blue Shield $4,155 3890%
Medical Associates Health Plan $4,155 3890%
Humana $4,155 3890%
Medicare (plans) $4,155 3890%
Medicaid / KanCare $4,155 3890%
Oscar Health - Commercial $4,155 3890%
Health Partners - Commercial (Unitypoint) $4,155 3890%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 Campus Dr, Clive, IA 50325
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL