CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $466
  • Cash Discount Price: $2,133
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Mercy Specialty Hospital Southeast Kansas is $466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,133. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.60x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$2,133

Average discount available for prompt cash payment at this facility.

Insurance Median
$466

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: $2,133 (1190%)
Insurance Median: $466 (260%)
Cash: $2,133 (1190% of Medicare)
Ins. Median: $466 (260% 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 260% of the Medicare baseline (a markup of 160%). 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 $99 - $170 55%
Medicaid / KanCare $99 - $251 55%
Humana $99 - $173 55%
Blue Cross Blue Shield $101 - $490 56%
Provider Partners Health Plans Contracted [320450] $105 59%
First Health Contracted [320128] $144 80%
UnitedHealthcare $152 - $3,036 85%
Halo Hcr Inc Hospice Contracted [320432] $170 95%
Cigna $170 - $1,097 95%
Pace Of The Ozarks Contracted [320518] $170 95%
Halo Hcr Inc Hospice [20432] $170 95%
Mercy Hospice Okc [20252] $170 95%
Globalhealth Contracted [320145] $170 95%
Qual Choice Contracted [320325] $170 95%
Tricare $170 95%
Mercy Mgd Behavioral Health Contracted [320259] $170 95%
Kindful Hospice Contracted [320434] $170 95%
Medicare (plans) $170 95%
Kindful Hospice [20434] $170 95%
Cross Timbers Hospice [20098] $170 95%
Elara Caring Aspire Hospice [20433] $170 95%
Cherokee Nation Health Serv Contracted [320066] $170 95%
Medical Associates Health Contracted [320444] $170 95%
Dept Of Veteran Affairs Contracted [320106] $173 97%
Centivo Contracted [320505] $173 97%
United Medical Resources Contracted [320454] $239 - $498 133%
Providrs Care Network Contracted [320484] $329 184%
Insurance System Inc Contracted [320465] $498 278%
Health Systems Inc Contracted [320174] $498 278%
Healthscope Contracted [320182] $498 - $2,462 278%
Benefit Management Contracted [320052] $498 278%
Point C Contracted [320238] $498 - $2,462 278%
Medica Contracted [320239] $734 410%
Mercy Benefit Admin Contracted [320251] $1,066 - $2,297 595%
Show-Me Health Administrators Contracted [320483] $1,066 595%
Aither Health Contracted [320449] $2,297 1282%
Reflect Health Contracted [320492] $2,297 1282%
Yuzu Health Contracted [320521] $2,297 1282%
American Healthcare Alliance Contracted [320020] $2,297 1282%
Ebms Contracted [320493] $2,297 1282%
Auxiant Contracted [320462] $2,297 - $2,462 1282%
Imagine 360 Contracted [320494] $2,297 1282%
Edison Health Solutions Contracted [320502] $2,297 1282%
Healthlink Contracted [320179] $2,462 1374%
Preferred Health Plan Contracted [320522] $2,462 1374%
Federal Medical Center Contracted [320127] $2,462 1374%
Compcare Of The Ozarks Contracted [320437] $2,593 1447%
Workers Comp [20426] $2,626 1465%
Private Health Care Systems Contracted [320320] $3,036 1694%
Multiplan [20270] $3,118 1740%
Multiplan Contracted [320270] $3,118 1740%

Consumer Guidance & Cost Commentary

For the CT scan of the head (with and without contrast) at Mercy Specialty Hospital Southeast Kansas, the facility's cash median price of $2,133 is significantly lower than the negotiated rates paid by most commercial insurers, which range from $99 to over $3,000 depending on the plan. While the facility's gross charge is $3,282, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds the cash price. It is important to note that many payers, including UnitedHealthcare and Point C Contracted, have negotiated rates that can reach as high as $2,462, meaning the cash option could save patients thousands of dollars. Additionally, the facility offers a prompt-pay discount for upfront payment, which can further reduce the final bill, and patients should explicitly ask for self-pay classification before scheduling to avoid automatic insurance submission.

This service is benchmarked against Medicare, which pays a fixed rate of $179.20 for this procedure, highlighting the substantial markup inherent in commercial billing structures. Although the data does not provide specific county or state average comparisons for this exact CPT code, the facility's cash rate of $2,133 serves as a critical reference point for consumers to evaluate potential savings. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab work are billed out-of-network. To protect against errors, consumers should always request a full itemized bill before paying, as summary invoices often obscure unbundled codes or services not rendered, and any disputes

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals