CMS Price Transparency Data
CT scan, sinuses
Facility: Mercy Hospital Joplin
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $551
- Cash Discount Price: $1,229
- vs. Medicare Baseline: 5.16x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital Joplin is $551. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,229. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.16x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$1,229
Average discount available for prompt cash payment at this facility.
Insurance Median
$551
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: $1,229 (1151%)
Insurance Median: $551 (516%)
Cash: $1,229 (1151% of Medicare)
Ins. Median: $551 (516% 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 516% of the Medicare baseline (a markup of 416%). 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.
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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 | $60 - $2,052 | 56% |
| Medicaid / KanCare | $60 - $199 | 56% |
| Indian Health Service Contracted [320198] | $73 - $1,830 | 68% |
| Aetna | $76 - $136 | 71% |
| Humana | $76 - $844 | 71% |
| Champva [20065] | $95 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $95 | 89% |
| Cigna | $95 - $467 | 89% |
| Cross Timbers Hospice [20098] | $95 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $95 | 89% |
| Elara Caring Aspire Hospice [20433] | $95 | 89% |
| Globalhealth Contracted [320145] | $95 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $95 | 89% |
| Halo Hcr Inc Hospice [20432] | $95 | 89% |
| Kindful Hospice Contracted [320434] | $95 | 89% |
| Kindful Hospice [20434] | $95 | 89% |
| Medicare (plans) | $95 - $100 | 89% |
| Mercy Hospice Okc [20252] | $95 | 89% |
| Mercy Mgd Behavioral Health Contracted [320259] | $95 | 89% |
| Pace Of The Ozarks Contracted [320518] | $95 | 89% |
| Provider Partners Health Plans Contracted [320450] | $95 | 89% |
| Qual Choice Contracted [320325] | $95 | 89% |
| Tricare | $95 | 89% |
| UnitedHealthcare | $95 - $245 | 89% |
| Centivo Contracted [320505] | $97 | 91% |
| Healthscope Contracted [320182] | $121 | 113% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Ambetter / Centene | $199 | 186% |
| Home State Health Plan Contracted [320187] | $199 | 186% |
| Novasys Contracted [320285] | $199 | 186% |
| United Medical Resources Contracted [320454] | $245 - $480 | 229% |
| Health Choice Contracted [320166] | $266 | 249% |
| Point C Contracted [320238] | $338 - $2,252 | 316% |
| Benefit Management Contracted [320052] | $416 - $1,210 | 389% |
| Health Systems Inc Contracted [320174] | $416 - $1,210 | 389% |
| Insurance System Inc Contracted [320465] | $416 - $1,210 | 389% |
| Administrative Payor Contracted [320005] | $435 - $1,267 | 407% |
| Mercy Benefit Admin Contracted [320251] | $484 - $1,605 | 453% |
| Aither Health Contracted [320449] | $551 - $1,605 | 516% |
| Auxiant Contracted [320462] | $551 - $1,830 | 516% |
| Ebms Contracted [320493] | $551 - $1,605 | 516% |
| Edison Health Solutions Contracted [320502] | $551 - $1,605 | 516% |
| Healthlink Contracted [320179] | $551 - $1,830 | 516% |
| Imagine 360 Contracted [320494] | $551 - $1,605 | 516% |
| Reflect Health Contracted [320492] | $551 - $1,605 | 516% |
| Yuzu Health Contracted [320521] | $551 - $1,605 | 516% |
| Preferred Health Plan Contracted [320522] | $629 - $1,830 | 589% |
| First Health Contracted [320128] | $659 - $1,917 | 617% |
| American Healthcare Alliance Contracted [320020] | $677 - $1,970 | 634% |
| Medica Contracted [320239] | $734 | 687% |
| Multiplan Contracted [320270] | $745 - $2,168 | 698% |
| Private Health Care Systems Contracted [320320] | $745 - $2,168 | 698% |
| Usable Contracted [320409] | $745 - $2,168 | 698% |
| 90 Degree Benefits Contracted [320436] | $765 | 716% |
| Show-Me Health Administrators Contracted [320483] | $765 - $804 | 716% |
| Point C [20238] | $774 - $2,252 | 725% |
| Workers Comp [20426] | $774 - $2,815 | 725% |
| Usa Managed Care Org Contracted [320429] | $851 - $2,477 | 797% |
| Ppo Plus Contracted [320310] | $870 - $2,534 | 815% |