CMS Price Transparency Data
CT scan, sinuses
Facility: Mercy St Francis Hospital
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $1,780
- Cash Discount Price: $1,324
- vs. Medicare Baseline: 16.67x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy St Francis Hospital is $1,780. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,324. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.67x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$1,324
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,780
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: $1,324 (1240%)
Insurance Median: $1,780 (1667%)
Cash: $1,324 (1240% of Medicare)
Ins. Median: $1,780 (1667% 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 1667% of the Medicare baseline (a markup of 1567%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $1,142 | 56% |
| Medicare (plans) | $99 - $786 | 93% |
| Blue Cross Blue Shield | $100 - $2,135 | 94% |
| UnitedHealthcare | $140 - $2,091 | 131% |
| Tricare | $637 - $748 | 596% |
| Aetna | $643 - $1,959 | 602% |
| Cherokee Nation Health Serv Contracted [320066] | $643 - $755 | 602% |
| Cigna | $643 - $2,091 | 602% |
| Cross Timbers Hospice [20098] | $643 - $755 | 602% |
| Dept Of Veteran Affairs Contracted [320106] | $643 - $755 | 602% |
| Elara Caring Aspire Hospice [20433] | $643 - $755 | 602% |
| Globalhealth Contracted [320145] | $643 - $755 | 602% |
| Halo Hcr Inc Hospice Contracted [320432] | $643 - $755 | 602% |
| Halo Hcr Inc Hospice [20432] | $643 - $755 | 602% |
| Humana | $643 - $1,981 | 602% |
| Indian Health Service Contracted [320198] | $643 - $755 | 602% |
| Kindful Hospice Contracted [320434] | $643 - $755 | 602% |
| Kindful Hospice [20434] | $643 - $755 | 602% |
| Medical Associates Health Contracted [320444] | $643 - $755 | 602% |
| Mercy Hospice Okc [20252] | $643 - $755 | 602% |
| Mercy Mgd Behavioral Health Contracted [320259] | $643 - $755 | 602% |
| Pace Of The Ozarks Contracted [320518] | $643 - $755 | 602% |
| Provider Partners Health Plans Contracted [320450] | $643 - $755 | 602% |
| Qual Choice Contracted [320325] | $643 - $755 | 602% |
| Administrative Payor Contracted [320005] | $843 - $990 | 789% |
| Healthscope Contracted [320182] | $855 - $1,004 | 800% |
| Ambetter / Centene | $973 - $1,142 | 911% |
| Home State Health Plan Contracted [320187] | $973 - $1,142 | 911% |
| Novasys Contracted [320285] | $973 - $1,142 | 911% |
| Centivo Contracted [320505] | $1,087 - $1,277 | 1018% |
| Healthlink Contracted [320179] | $1,218 - $2,091 | 1140% |
| Preferred Health Plan Contracted [320522] | $1,218 - $1,431 | 1140% |
| Workers Comp [20426] | $1,499 - $1,871 | 1403% |
| Auxiant Contracted [320462] | $1,687 - $2,091 | 1579% |
| Mercy Benefit Admin Contracted [320251] | $1,687 - $2,091 | 1579% |
| Point C Contracted [320238] | $1,687 - $2,091 | 1579% |
| United Medical Resources Contracted [320454] | $1,687 - $2,047 | 1579% |
| Medica Contracted [320239] | $1,771 - $2,080 | 1658% |
| 90 Degree Benefits Contracted [320436] | $1,780 - $2,091 | 1667% |
| Aither Health Contracted [320449] | $1,780 - $2,091 | 1667% |
| Benefit Management Contracted [320052] | $1,780 - $2,091 | 1667% |
| Ebms Contracted [320493] | $1,780 - $2,091 | 1667% |
| Edison Health Solutions Contracted [320502] | $1,780 - $2,091 | 1667% |
| Evolutions Health Care Contracted [320124] | $1,780 - $2,091 | 1667% |
| First Health Contracted [320128] | $1,780 - $2,091 | 1667% |
| Health Systems Inc Contracted [320174] | $1,780 - $2,091 | 1667% |
| Imagine 360 Contracted [320494] | $1,780 - $2,091 | 1667% |
| Insurance System Inc Contracted [320465] | $1,780 - $2,091 | 1667% |
| Multiplan Contracted [320270] | $1,780 - $2,091 | 1667% |
| Point C [20238] | $1,780 - $2,091 | 1667% |
| Private Health Care Systems Contracted [320320] | $1,780 - $2,091 | 1667% |
| Reflect Health Contracted [320492] | $1,780 - $2,091 | 1667% |
| Show-Me Health Administrators Contracted [320483] | $1,780 - $2,091 | 1667% |
| Usa Managed Care Org Contracted [320429] | $1,780 - $2,091 | 1667% |
| Yuzu Health Contracted [320521] | $1,780 - $2,091 | 1667% |