CT scan, sinuses
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $2,198
- Cash Discount Price: $1,860
- vs. Medicare Baseline: 20.58x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 2058% of the Medicare baseline (a markup of 1958%). 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.
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 | $60 - $578 | 56% |
| Medicaid / KanCare | $60 - $104 | 56% |
| Humana | $76 - $102 | 71% |
| Aetna | $76 - $2,530 | 71% |
| UnitedHealthcare | $91 - $2,006 | 85% |
| Kindful Hospice [20434] | $102 | 95% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Tricare | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $102 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $102 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| Medicare (plans) | $102 - $106 | 95% |
| Ambetter / Centene | $104 | 97% |
| Home State Health Plan Contracted [320187] | $104 | 97% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Health Choice Contracted [320166] | $292 | 273% |
| Cigna | $455 - $467 | 426% |
| Medica Contracted [320239] | $734 | 687% |
| United Medical Resources Contracted [320454] | $1,852 - $2,006 | 1734% |
| American Healthcare Alliance Contracted [320020] | $2,198 - $2,381 | 2058% |
| Workers Comp [20426] | $2,198 - $2,381 | 2058% |
| Auxiant Contracted [320462] | $2,198 - $2,381 | 2058% |
| Aither Health Contracted [320449] | $2,198 - $2,381 | 2058% |
| Healthlink Contracted [320179] | $2,198 - $2,381 | 2058% |
| Edison Health Solutions Contracted [320502] | $2,198 - $2,381 | 2058% |
| Mercy Benefit Admin Contracted [320251] | $2,198 - $2,381 | 2058% |
| Yuzu Health Contracted [320521] | $2,198 - $2,381 | 2058% |
| Imagine 360 Contracted [320494] | $2,198 - $2,381 | 2058% |
| Reflect Health Contracted [320492] | $2,198 - $2,381 | 2058% |
| Ebms Contracted [320493] | $2,198 - $2,381 | 2058% |
| First Health Contracted [320128] | $2,336 - $2,530 | 2187% |
Consumer Guidance & Cost Commentary
For the CT scan of the sinuses (CPT 70486) at Mercy Hospital Pittsburg, Inc., the facility's cash price of $1,860 is significantly lower than the gross chargemaster rate of $2,862. While many commercial payers have negotiated rates ranging from $60 to over $2,500, the cash price is notably lower than the median negotiated rate of $2,198 observed across the 36 payers listed. This price transparency data highlights that for patients with high-deductible plans or those without insurance, paying the cash price directly may be more cost-effective than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status and ask the hospital directly about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can further reduce the final out-of-pocket cost.
The facility's pricing also compares favorably against the Medicare benchmark, with the cash rate representing a markup of approximately 175% of the Medicare amount of $106.81, which falls within the range of fair pricing typically defined between 120% and 150% of Medicare. Although the facility is a voluntary non-profit church-owned acute care hospital in Pittsburg, KS, and holds a rating of 3, the wide variance in commercial payer rates—from as low as $60 for Medicaid/KanCare to over $2,500 for some contracted entities—underscores the importance of checking individual plan details. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities