CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Mercy Hospital Joplin

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $740
Cash Discount Price: $1,864
vs. Medicare Baseline: 4.13x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Mercy Hospital Joplin is $740. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,864. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.13x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$1,864

Average discount available for prompt cash payment at this facility.

Insurance Median

$740

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: $1,864 (1040%)

Insurance Median: $740 (413%)

Cash: $1,864 (1040% of Medicare)

Ins. Median: $740 (413% 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 413% of the Medicare baseline (a markup of 313%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$80 - $2,090	45%
Indian Health Service Contracted [320198]	$80 - $1,864	45%
Aetna	$82 - $159	46%
Humana	$82 - $154	46%
Medicaid / KanCare	$82 - $273	46%
Champva [20065]	$159	89%
Cherokee Nation Health Serv Contracted [320066]	$159	89%
Cigna	$159 - $1,097	89%
Cross Timbers Hospice [20098]	$159	89%
Dept Of Veteran Affairs Contracted [320106]	$159	89%
Elara Caring Aspire Hospice [20433]	$159	89%
Globalhealth Contracted [320145]	$159	89%
Halo Hcr Inc Hospice Contracted [320432]	$159	89%
Halo Hcr Inc Hospice [20432]	$159	89%
Kindful Hospice Contracted [320434]	$159	89%
Kindful Hospice [20434]	$159	89%
Medicare (plans)	$159 - $167	89%
Mercy Hospice Okc [20252]	$159	89%
Mercy Mgd Behavioral Health Contracted [320259]	$159	89%
Pace Of The Ozarks Contracted [320518]	$159	89%
Provider Partners Health Plans Contracted [320450]	$159	89%
Qual Choice Contracted [320325]	$159	89%
Tricare	$159	89%
UnitedHealthcare	$159 - $402	89%
Centivo Contracted [320505]	$162	90%
Healthscope Contracted [320182]	$202	113%
Ambetter / Centene	$230	128%
Home State Health Plan Contracted [320187]	$230	128%
Novasys Contracted [320285]	$230	128%
Providrs Care Network Contracted [320484]	$329	184%
United Medical Resources Contracted [320454]	$402 - $751	224%
Health Choice Contracted [320166]	$445	248%
Healthlink Contracted [320179]	$648 - $1,864	362%
Medica Contracted [320239]	$734	410%
90 Degree Benefits Contracted [320436]	$847	473%
Mercy Benefit Admin Contracted [320251]	$847 - $1,634	473%
Show-Me Health Administrators Contracted [320483]	$847 - $890	473%
Point C Contracted [320238]	$1,003 - $2,294	560%
Benefit Management Contracted [320052]	$1,233	688%
Health Systems Inc Contracted [320174]	$1,233	688%
Insurance System Inc Contracted [320465]	$1,233	688%
Administrative Payor Contracted [320005]	$1,290	720%
Aither Health Contracted [320449]	$1,634	912%
Auxiant Contracted [320462]	$1,634 - $1,864	912%
Ebms Contracted [320493]	$1,634	912%
Edison Health Solutions Contracted [320502]	$1,634	912%
Imagine 360 Contracted [320494]	$1,634	912%
Reflect Health Contracted [320492]	$1,634	912%
Yuzu Health Contracted [320521]	$1,634	912%
Preferred Health Plan Contracted [320522]	$1,864	1040%
First Health Contracted [320128]	$1,952	1089%
American Healthcare Alliance Contracted [320020]	$2,007	1120%
Multiplan Contracted [320270]	$2,208	1232%
Private Health Care Systems Contracted [320320]	$2,208	1232%
Usable Contracted [320409]	$2,208	1232%
Point C [20238]	$2,294	1280%
Workers Comp [20426]	$2,294 - $2,867	1280%
Usa Managed Care Org Contracted [320429]	$2,523	1408%
Ppo Plus Contracted [320310]	$2,580	1440%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,864.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Joplin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.