CMS Price Transparency Data

CT scan, sinuses

Facility: Mercy Hospital St Louis

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $240
  • Cash Discount Price: $1,298
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital St Louis is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,298. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$1,298

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $1,298 (1215%)
Insurance Median: $240 (225%)
Cash: $1,298 (1215% of Medicare)
Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). 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 $91 - $350 85%
Aetna $99 - $152 93%
American Health Advantage Of Mo Mcr [10473] $99 93%
Blue Cross Blue Shield $99 - $2,101 93%
Cherokee Nation Health Serv Contracted [320066] $99 93%
Cross Timbers Hospice [20098] $99 93%
Dept Of Veteran Affairs Contracted [320106] $99 93%
Elara Caring Aspire Hospice Contracted [320433] $99 93%
Elara Caring Aspire Hospice [20433] $99 93%
Globalhealth Contracted [320145] $99 93%
Halo Hcr Inc Hospice Contracted [320432] $99 93%
Halo Hcr Inc Hospice [20432] $99 93%
Humana $99 93%
Kindful Hospice Contracted [320434] $99 93%
Kindful Hospice [20434] $99 93%
Medicare (plans) $99 - $2,334 93%
Mercy Hospice Okc [20252] $99 93%
Pace Of The Ozarks Contracted [320518] $99 93%
Qual Choice Contracted [320325] $99 93%
Tricare $99 93%
UnitedHealthcare $99 - $136 93%
Cigna $101 - $1,050 95%
Hope Trust Contracted [320488] $101 95%
Provider Partners Health Plans Contracted [320450] $109 102%
Healthscope Contracted [320182] $126 118%
United Medical Resources Contracted [320454] $136 127%
Centivo Contracted [320505] $166 155%
Preferred Health Plan Contracted [320522] $176 165%
Ambetter / Centene $219 205%
Home State Health Plan Contracted [320187] $219 205%
Novasys Contracted [320285] $219 205%
Aither Health Contracted [320449] $240 225%
Aither Health [20449] $240 225%
Auxiant Contracted [320462] $240 225%
Ebms Contracted [320493] $240 225%
Edison Health Solutions Contracted [320502] $240 225%
Healthlink Contracted [320179] $240 - $1,587 225%
Imagine 360 Contracted [320494] $240 225%
Mercy Benefit Admin Contracted [320251] $240 - $298 225%
Mercy Benefit Admin [20251] $240 - $298 225%
Reflect Health Contracted [320492] $240 225%
Show-Me Health Administrators Contracted [320483] $240 225%
Yuzu Health Contracted [320521] $240 225%
Medica Contracted [320239] $261 244%
Workers Comp [20426] $525 - $1,867 492%
Health Choices Contracted [320448] $995 - $1,400 932%
Health Choices [20448] $995 - $1,400 932%
Medical Associates Health Contracted [320444] $995 - $1,400 932%
Federal Medical Center Contracted [320127] $1,078 - $1,517 1009%
Insurance System Inc Contracted [320465] $1,078 - $1,517 1009%
Point C Contracted [320238] $1,078 - $1,517 1009%
Tri State Healthcare Coalition Contracted [320379] $1,078 - $1,517 1009%
First Health Contracted [320128] $1,178 - $1,657 1103%
Multiplan Contracted [320270] $1,244 - $1,750 1165%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals