CMS Price Transparency Data

CT scan, sinuses

Facility: Salem Memorial District Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,382
  • Cash Discount Price: $1,295
  • vs. Medicare Baseline: 12.94x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Salem Memorial District Hospital is $1,382. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,295. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.94x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$1,295

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,382

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: $1,295 (1212%)
Insurance Median: $1,382 (1294%)
Cash: $1,295 (1212% of Medicare)
Ins. Median: $1,382 (1294% 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 1294% of the Medicare baseline (a markup of 1194%). 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
Aetna $587 - $1,555 550%
Ambetter / Centene $587 550%
Blue Cross Blue Shield $587 - $1,641 550%
Humana $587 - $1,468 550%
Tricare $587 550%
Triwest $587 550%
UnitedHealthcare $587 550%
Veteran'S Affairs $587 550%
Healthlink $1,123 1051%
First Health $1,382 1294%
Mercy - C.B. Management Company/Joplin Supply Company $1,382 1294%
Mercy - City Of Springfield $1,382 1294%
Mercy - Clayco $1,382 1294%
Mercy - Commerce Bank $1,382 1294%
Mercy - Diversified Plastics $1,382 1294%
Mercy - Employers Benefit Alliance $1,382 1294%
Mercy - Evolutions $1,382 1294%
Mercy - Fabick Cat $1,382 1294%
Mercy - Firsthealth Network $1,382 1294%
Mercy - Health Management Network $1,382 1294%
Mercy - Health Systems Inc $1,382 1294%
Mercy - Liberty Utilities/Empire District Electric $1,382 1294%
Mercy - Life Church $1,382 1294%
Mercy - Missouri State University $1,382 1294%
Mercy - Prime Health Services $1,382 1294%
Mercy - Quiktrip Corporation $1,382 1294%
Mercy - Shinesolar $1,382 1294%
Mercy - Springfield Public Schools $1,382 1294%
Mercy - Springfield Remanufacturing $1,382 1294%
Mercy - Sumnerone $1,382 1294%
Mercy - Trailiner $1,382 1294%
Mercy - Walmart Mercy Accountable Care Plan $1,382 1294%
Mercy-American Healthcare Alliance $1,382 1294%
Phcs $1,382 - $1,468 1294%
Cigna $1,466 1373%
Mercy - Compresults $1,555 1456%
Mercy - Corvel Corporation $1,555 1456%
Mercy - Novasys $1,555 1456%
Mercy - Scurlock Industries $1,555 1456%
Mercy - Usa Managed Care Organization $1,555 1456%
Right Choice-Alliance $1,641 1536%
Right Choice-Regular $1,675 1568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals