CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Mercy Hospital Carthage

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,237
Cash Discount Price: $1,464
vs. Medicare Baseline: 6.90x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Mercy Hospital Carthage is $1,237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,464. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 6.90x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,464

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,237

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Cash / Self-Pay: $1,464 (817%)

Insurance Median: $1,237 (690%)

Cash: $1,464 (817% of Medicare)

Ins. Median: $1,237 (690% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 690% of the Medicare baseline (a markup of 590%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$99 - $2,005	55%
Humana	$99 - $676	55%
Medicaid / KanCare	$99 - $1,237	55%
Blue Cross Blue Shield	$101 - $619	56%
Medicare (plans)	$167 - $667	93%
UnitedHealthcare	$234 - $1,960	131%
Cherokee Nation Health Serv Contracted [320066]	$619	345%
Cigna	$619 - $2,028	345%
Cross Timbers Hospice [20098]	$619	345%
Dept Of Veteran Affairs Contracted [320106]	$619	345%
Elara Caring Aspire Hospice [20433]	$619	345%
Globalhealth Contracted [320145]	$619	345%
Halo Hcr Inc Hospice Contracted [320432]	$619	345%
Halo Hcr Inc Hospice [20432]	$619	345%
Indian Health Service Contracted [320198]	$619	345%
Kindful Hospice Contracted [320434]	$619	345%
Kindful Hospice [20434]	$619	345%
Medical Associates Health Contracted [320444]	$619	345%
Mercy Hospice Okc [20252]	$619	345%
Mercy Mgd Behavioral Health Contracted [320259]	$619	345%
Pace Of The Ozarks Contracted [320518]	$619	345%
Provider Partners Health Plans Contracted [320450]	$619	345%
Qual Choice Contracted [320325]	$619	345%
Tricare	$621	347%
Point C Contracted [320238]	$789 - $2,028	440%
Health Systems Inc Contracted [320174]	$969	541%
Insurance System Inc Contracted [320465]	$969	541%
Administrative Payor Contracted [320005]	$1,014	566%
United Medical Resources Contracted [320454]	$1,031 - $2,028	575%
Centivo Contracted [320505]	$1,036	578%
Healthscope Contracted [320182]	$1,174	655%
Ambetter / Centene	$1,237	690%
Home State Health Plan Contracted [320187]	$1,237	690%
Novasys Contracted [320285]	$1,237	690%
Benefit Management Contracted [320052]	$1,352 - $1,960	754%
Auxiant Contracted [320462]	$1,464 - $1,915	817%
Healthlink Contracted [320179]	$1,464 - $2,095	817%
Preferred Health Plan Contracted [320522]	$1,464	817%
Workers Comp [20426]	$1,802 - $2,253	1006%
90 Degree Benefits Contracted [320436]	$1,915	1069%
Aither Health Contracted [320449]	$1,915	1069%
Ebms Contracted [320493]	$1,915	1069%
Edison Health Solutions Contracted [320502]	$1,915	1069%
Imagine 360 Contracted [320494]	$1,915	1069%
Mercy Benefit Admin Contracted [320251]	$1,915 - $2,028	1069%
Reflect Health Contracted [320492]	$1,915	1069%
Show-Me Health Administrators Contracted [320483]	$1,915	1069%
Yuzu Health Contracted [320521]	$1,915	1069%
Medica Contracted [320239]	$1,951	1089%
Evolutions Health Care Contracted [320124]	$1,960	1094%
First Health Contracted [320128]	$1,960	1094%
Multiplan Contracted [320270]	$1,960	1094%
Private Health Care Systems Contracted [320320]	$1,960	1094%
American Healthcare Alliance Contracted [320020]	$2,028	1132%
Ppo Plus Contracted [320310]	$2,028	1132%
Usa Managed Care Org Contracted [320429]	$2,028	1132%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,464.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Carthage is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.