CMS Price Transparency Data

CT scan, sinuses

Facility: Mercy Hospital Columbus

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,075
  • Cash Discount Price: $1,085
  • vs. Medicare Baseline: 10.06x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital Columbus is $1,075. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,085. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.06x the Medicare baseline. Located in 220 N Pennsylvania Avenue, Columbus, KS.
Cash / Self-Pay
$1,085

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,075

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: $1,085 (1016%)
Insurance Median: $1,075 (1006%)
Cash: $1,085 (1016% of Medicare)
Ins. Median: $1,075 (1006% 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 1006% of the Medicare baseline (a markup of 906%). 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
Centivo Contracted [320505] $12 - $22 11%
Humana $76 - $2,095 71%
Medicaid / KanCare $76 - $1,601 71%
UnitedHealthcare $91 - $1,830 85%
Blue Cross Blue Shield $91 - $1,601 85%
Medicare (plans) $100 - $1,665 94%
Health Systems Inc Contracted [320174] $487 - $948 456%
Insurance System Inc Contracted [320465] $487 - $948 456%
Administrative Payor Contracted [320005] $509 - $992 477%
Kindful Hospice [20434] $822 - $1,601 770%
Ambetter / Centene $822 - $1,601 770%
Dept Of Veteran Affairs Contracted [320106] $822 - $1,601 770%
Halo Hcr Inc Hospice [20432] $822 - $1,601 770%
Qual Choice Contracted [320325] $822 - $1,601 770%
Pace Of The Ozarks Contracted [320518] $822 - $1,601 770%
Cherokee Nation Health Serv Contracted [320066] $822 - $1,601 770%
Cigna $822 - $1,601 770%
Cross Timbers Hospice [20098] $822 - $1,601 770%
Mercy Mgd Behavioral Health Contracted [320259] $822 - $1,601 770%
Home State Health Plan Contracted [320187] $822 - $1,601 770%
Mercy Hospice Okc [20252] $822 - $1,601 770%
Halo Hcr Inc Hospice Contracted [320432] $822 - $1,601 770%
Elara Caring Aspire Hospice [20433] $822 - $1,601 770%
Provider Partners Health Plans Contracted [320450] $822 - $1,601 770%
Globalhealth Contracted [320145] $822 - $1,601 770%
Aetna $822 - $1,984 770%
Novasys Contracted [320285] $822 - $1,601 770%
Indian Health Service Contracted [320198] $822 - $1,601 770%
Kindful Hospice Contracted [320434] $822 - $1,601 770%
Centurion Of Missouri [20459] $822 - $1,601 770%
Medical Associates Health Contracted [320444] $822 - $1,601 770%
Tricare $824 - $1,606 771%
Healthscope Contracted [320182] $873 - $1,700 817%
Workers Comp [20426] $906 - $1,874 848%
United Medical Resources Contracted [320454] $940 - $2,095 880%
Medica Contracted [320239] $1,014 - $1,976 949%
Federal Medical Center Contracted [320127] $1,019 - $1,984 954%
First Health Contracted [320128] $1,019 - $1,984 954%
Healthlink Contracted [320179] $1,019 - $2,095 954%
Preferred Health Plan Contracted [320522] $1,019 - $1,984 954%
Usa Managed Care Org Contracted [320429] $1,019 - $1,984 954%
Mercy Benefit Admin Contracted [320251] $1,019 - $2,095 954%
American Healthcare Alliance Contracted [320020] $1,019 - $1,984 954%
Show-Me Health Administrators Contracted [320483] $1,075 - $2,095 1006%
Ppo Plus Contracted [320310] $1,075 - $2,095 1006%
Benefit Management Contracted [320052] $1,075 - $2,095 1006%
Private Health Care Systems Contracted [320320] $1,075 - $2,095 1006%
Point C Contracted [320238] $1,075 - $2,095 1006%
Ebms Contracted [320493] $1,075 - $2,095 1006%
Auxiant Contracted [320462] $1,075 - $2,095 1006%
Imagine 360 Contracted [320494] $1,075 - $2,095 1006%
Edison Health Solutions Contracted [320502] $1,075 - $2,095 1006%
Aither Health Contracted [320449] $1,075 - $2,095 1006%
Reflect Health Contracted [320492] $1,075 - $2,095 1006%
Yuzu Health Contracted [320521] $1,075 - $2,095 1006%
90 Degree Benefits Contracted [320436] $1,075 - $2,095 1006%

Consumer Guidance & Cost Commentary

For a CT scan of the sinuses at Mercy Hospital Columbus, the facility's cash price is $1,085, which is notably higher than the state average cash median of $1,085. While the facility offers a negotiated rate of $1,075 for in-network patients, this amount remains significantly above the state's average negotiated rate of $1,075. It is important to note that for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than using insurance, as the insurance negotiated rate often exceeds the cash price due to administrative overhead. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket may result in lower immediate costs if the insurance allowed amount is higher than the cash rate.

To avoid unexpected costs, patients should request a prompt-pay discount if they choose to pay the bill in full upfront, as hospitals often offer reductions of 20% to 50% for immediate payment to bypass costly claims processing. Additionally, if you are using insurance, ensure you receive an itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected through a formal audit. If you encounter a balance bill for out-of-network services, you may have protections under the No Surprises Act, which bans surprise billing for emergency care and non-emergency services at in-network facilities. Always dispute any unexpected charges in writing to ensure accuracy and protect yourself from potential overcharges.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 N Pennsylvania Avenue, Columbus, KS 66725
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals