CT scan, sinuses
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,100
- Cash Discount Price: $1,328
- vs. Medicare Baseline: 10.30x 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 1030% of the Medicare baseline (a markup of 930%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $178 | 56% |
| Blue Cross Blue Shield | $60 - $490 | 56% |
| Aetna | $76 - $111 | 71% |
| Humana | $76 - $104 | 71% |
| Provider Partners Health Plans Contracted [320450] | $81 | 76% |
| UnitedHealthcare | $91 - $2,326 | 85% |
| Kindful Hospice [20434] | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| Medicare (plans) | $102 | 95% |
| Tricare | $102 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $102 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $102 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| Medical Associates Health Contracted [320444] | $102 | 95% |
| Qual Choice Contracted [320325] | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Cigna | $102 - $467 | 95% |
| Globalhealth Contracted [320145] | $102 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $104 | 97% |
| Centivo Contracted [320505] | $104 | 97% |
| First Health Contracted [320128] | $111 | 104% |
| United Medical Resources Contracted [320454] | $114 - $376 | 107% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Health Systems Inc Contracted [320174] | $376 | 352% |
| Point C Contracted [320238] | $376 - $1,886 | 352% |
| Healthscope Contracted [320182] | $376 - $1,886 | 352% |
| Insurance System Inc Contracted [320465] | $376 | 352% |
| Benefit Management Contracted [320052] | $376 | 352% |
| Medica Contracted [320239] | $734 | 687% |
| Show-Me Health Administrators Contracted [320483] | $804 | 753% |
| Mercy Benefit Admin Contracted [320251] | $804 - $1,760 | 753% |
| Yuzu Health Contracted [320521] | $1,100 - $1,760 | 1030% |
| Auxiant Contracted [320462] | $1,100 - $1,886 | 1030% |
| Ebms Contracted [320493] | $1,100 - $1,760 | 1030% |
| American Healthcare Alliance Contracted [320020] | $1,100 - $1,760 | 1030% |
| Edison Health Solutions Contracted [320502] | $1,100 - $1,760 | 1030% |
| Reflect Health Contracted [320492] | $1,100 - $1,760 | 1030% |
| Aither Health Contracted [320449] | $1,100 - $1,760 | 1030% |
| Imagine 360 Contracted [320494] | $1,100 - $1,760 | 1030% |
| Healthlink Contracted [320179] | $1,178 - $1,886 | 1103% |
| Preferred Health Plan Contracted [320522] | $1,178 - $1,886 | 1103% |
| Federal Medical Center Contracted [320127] | $1,178 - $1,886 | 1103% |
| Compcare Of The Ozarks Contracted [320437] | $1,241 - $1,987 | 1162% |
| Workers Comp [20426] | $1,257 - $2,012 | 1177% |
| Private Health Care Systems Contracted [320320] | $1,453 - $2,326 | 1360% |
| Multiplan [20270] | $1,492 - $2,389 | 1397% |
| Multiplan Contracted [320270] | $1,492 - $2,389 | 1397% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Mercy Specialty Hospital Southeast Kansas, the facility's cash price is $1,328, which is notably higher than the state average for this service. While many commercial payers negotiate rates that can range from $60 to over $2,300 depending on the specific plan, the cash price often serves as a useful benchmark for patients with high-deductible plans or those without insurance, as it may be lower than the final amount an insurer allows after applying deductibles and copays. It is important to note that while the facility lists a median negotiated rate of $1,100, this figure represents the average amount insurers pay across 51 different payers and does not guarantee the specific rate for your individual plan; some contracts show significantly higher allowed amounts, such as UnitedHealthcare's range of $91 to $2,326.
Patients should proactively contact the hospital's billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final cost by 20% to 50% if settled upfront, bypassing the administrative costs associated with insurance claims processing. If you do receive a bill from an out-of-network provider, such as certain ancillary services or specialists, you may be subject to balance billing for the difference between the provider's full charge and your insurance's allowed amount, though the No Surprises Act protects you from these unexpected bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, always request a detailed, itemized bill that breaks down every CPT code and charge, as summary bills can obscure errors or unbundled services, and you have the