CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70460
  • Insurance Median: $416
  • Cash Discount Price: $1,713
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Mercy Specialty Hospital Southeast Kansas is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,713. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 2.32x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$1,713

Average discount available for prompt cash payment at this facility.

Insurance Median
$416

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: $1,713 (956%)
Insurance Median: $416 (232%)
Cash: $1,713 (956% of Medicare)
Ins. Median: $416 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Medicaid / KanCare $82 - $208 46%
Aetna $82 - $170 46%
Humana $82 - $173 46%
Blue Cross Blue Shield $86 - $490 48%
Provider Partners Health Plans Contracted [320450] $88 49%
First Health Contracted [320128] $120 67%
UnitedHealthcare $152 - $2,437 85%
Cross Timbers Hospice [20098] $170 95%
Pace Of The Ozarks Contracted [320518] $170 95%
Cigna $170 - $1,097 95%
Elara Caring Aspire Hospice [20433] $170 95%
Globalhealth Contracted [320145] $170 95%
Medicare (plans) $170 95%
Halo Hcr Inc Hospice Contracted [320432] $170 95%
Medical Associates Health Contracted [320444] $170 95%
Qual Choice Contracted [320325] $170 95%
Halo Hcr Inc Hospice [20432] $170 95%
Mercy Hospice Okc [20252] $170 95%
Mercy Mgd Behavioral Health Contracted [320259] $170 95%
Kindful Hospice Contracted [320434] $170 95%
Tricare $170 95%
Kindful Hospice [20434] $170 95%
Cherokee Nation Health Serv Contracted [320066] $170 95%
Dept Of Veteran Affairs Contracted [320106] $173 97%
Centivo Contracted [320505] $173 97%
United Medical Resources Contracted [320454] $239 - $416 133%
Providrs Care Network Contracted [320484] $329 184%
Insurance System Inc Contracted [320465] $416 232%
Benefit Management Contracted [320052] $416 232%
Point C Contracted [320238] $416 - $1,976 232%
Healthscope Contracted [320182] $416 - $1,976 232%
Health Systems Inc Contracted [320174] $416 232%
Medica Contracted [320239] $734 410%
Show-Me Health Administrators Contracted [320483] $890 497%
Mercy Benefit Admin Contracted [320251] $890 - $1,844 497%
Yuzu Health Contracted [320521] $1,844 1029%
Aither Health Contracted [320449] $1,844 1029%
Edison Health Solutions Contracted [320502] $1,844 1029%
Reflect Health Contracted [320492] $1,844 1029%
Imagine 360 Contracted [320494] $1,844 1029%
American Healthcare Alliance Contracted [320020] $1,844 1029%
Auxiant Contracted [320462] $1,844 - $1,976 1029%
Ebms Contracted [320493] $1,844 1029%
Federal Medical Center Contracted [320127] $1,976 1103%
Healthlink Contracted [320179] $1,976 1103%
Preferred Health Plan Contracted [320522] $1,976 1103%
Compcare Of The Ozarks Contracted [320437] $2,082 1162%
Workers Comp [20426] $2,108 1176%
Private Health Care Systems Contracted [320320] $2,437 1360%
Multiplan Contracted [320270] $2,503 1397%
Multiplan [20270] $2,503 1397%

Consumer Guidance & Cost Commentary

For the CT scan of the head with contrast (CPT 70460) at Mercy Specialty Hospital Southeast Kansas, the facility's cash median price is $1,713, which is lower than the gross charge of $2,635. While many commercial payers have negotiated rates ranging from $82 to $2,503, the cash price can be a more cost-effective option for patients with high-deductible plans or those without insurance, as it avoids the administrative markup inherent in insurance billing. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.

The facility's pricing is benchmarked against the Medicare rate of $179.20, with the cash median representing approximately 9.5 times the Medicare amount. Although the data does not provide specific state or county average comparisons for this procedure, the wide variance in negotiated rates across 51 different payers highlights that commercial rates can fluctuate significantly based on contract terms. To ensure you are receiving a fair price, we recommend requesting a full itemized bill to review every line item and code, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered. If you receive a bill that appears inflated, you have the right to dispute it in writing with the billing supervisor to correct any inaccuracies before payment.

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