CMS Price Transparency Data
CT scan, sinuses
Facility: Mercy Hospital Lincoln
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $445
- Cash Discount Price: $1,134
- vs. Medicare Baseline: 4.17x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital Lincoln is $445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,134. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.17x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$1,134
Average discount available for prompt cash payment at this facility.
Insurance Median
$445
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: $1,134 (1062%)
Insurance Median: $445 (417%)
Cash: $1,134 (1062% of Medicare)
Ins. Median: $445 (417% 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 417% of the Medicare baseline (a markup of 317%). 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 | $15 - $868 | 14% |
| Aetna | $34 - $1,239 | 32% |
| Medicare (plans) | $48 - $1,891 | 45% |
| Tricare | $48 - $405 | 45% |
| UnitedHealthcare | $49 - $1,248 | 46% |
| Provider Partners Health Plans Contracted [320450] | $52 - $442 | 49% |
| American Health Advantage Of Mo Mcr [10473] | $53 - $445 | 50% |
| Blue Cross Blue Shield | $53 - $1,456 | 50% |
| Cherokee Nation Health Serv Contracted [320066] | $53 - $445 | 50% |
| Cross Timbers Hospice [20098] | $53 - $445 | 50% |
| Dept Of Veteran Affairs Contracted [320106] | $53 - $445 | 50% |
| Elara Caring Aspire Hospice Contracted [320433] | $53 - $445 | 50% |
| Elara Caring Aspire Hospice [20433] | $53 - $445 | 50% |
| Globalhealth Contracted [320145] | $53 - $445 | 50% |
| Halo Hcr Inc Hospice Contracted [320432] | $53 - $445 | 50% |
| Halo Hcr Inc Hospice [20432] | $53 - $445 | 50% |
| Humana | $53 - $1,702 | 50% |
| Indian Health Service Contracted [320198] | $53 - $445 | 50% |
| Kindful Hospice Contracted [320434] | $53 - $445 | 50% |
| Kindful Hospice [20434] | $53 - $445 | 50% |
| Mercy Hospice Okc [20252] | $53 - $445 | 50% |
| Pace Of The Ozarks Contracted [320518] | $53 - $445 | 50% |
| Qual Choice Contracted [320325] | $53 - $445 | 50% |
| Cigna | $56 - $1,570 | 52% |
| Centivo Contracted [320505] | $81 - $686 | 76% |
| Medica Contracted [320239] | $94 - $794 | 88% |
| Ambetter / Centene | $103 - $868 | 96% |
| Home State Health Plan Contracted [320187] | $103 - $868 | 96% |
| Novasys Contracted [320285] | $103 - $868 | 96% |
| Hope Trust Contracted [320488] | $111 - $936 | 104% |
| Health Choices Contracted [320448] | $134 - $1,135 | 125% |
| Health Choices [20448] | $134 - $1,135 | 125% |
| Medical Associates Health Contracted [320444] | $134 - $1,135 | 125% |
| First Health Contracted [320128] | $147 - $1,239 | 138% |
| United Medical Resources Contracted [320454] | $148 - $1,248 | 139% |
| Mercy Mgd Behavioral Health Contracted [320259] | $168 | 157% |
| Multiplan Contracted [320270] | $168 - $1,418 | 157% |
| Private Health Care Systems Contracted [320320] | $168 | 157% |
| Workers Comp [20426] | $168 - $1,513 | 157% |
| Healthlink Contracted [320179] | $181 - $1,683 | 169% |
| Aither Health Contracted [320449] | $190 - $1,607 | 178% |
| Aither Health [20449] | $190 - $1,607 | 178% |
| Auxiant Contracted [320462] | $190 - $1,607 | 178% |
| Ebms Contracted [320493] | $190 - $1,607 | 178% |
| Edison Health Solutions Contracted [320502] | $190 - $1,607 | 178% |
| Federal Medical Center Contracted [320127] | $190 - $1,607 | 178% |
| Imagine 360 Contracted [320494] | $190 - $1,607 | 178% |
| Insurance System Inc Contracted [320465] | $190 - $1,607 | 178% |
| Mercy Benefit Admin Contracted [320251] | $190 - $1,607 | 178% |
| Mercy Benefit Admin [20251] | $190 - $1,607 | 178% |
| Point C Contracted [320238] | $190 - $1,607 | 178% |
| Preferred Health Plan Contracted [320522] | $190 - $1,607 | 178% |
| Reflect Health Contracted [320492] | $190 - $1,607 | 178% |
| Show-Me Health Administrators Contracted [320483] | $190 - $1,607 | 178% |
| Tri State Healthcare Coalition Contracted [320379] | $190 - $1,607 | 178% |
| Yuzu Health Contracted [320521] | $190 - $1,607 | 178% |