CMS Price Transparency Data

CT scan, sinuses

Facility: The Children's Mercy Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $116
Cash Discount Price: $871
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at The Children's Mercy Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $871. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.09x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$871

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $871 (815%)

Insurance Median: $116 (109%)

Cash: $871 (815% of Medicare)

Ins. Median: $116 (109% 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.

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
UnitedHealthcare	$35 - $2,335	33%
Healthy Blue	$37 - $273	35%
Medicaid / KanCare	$38 - $70	36%
Home State Health	$50 - $240	47%
Cigna	$52 - $2,415	49%
Healthlink	$52 - $3,058	49%
Wppa Providrs Care	$52 - $2,259	49%
Health Midwest Comprehensive Care	$55 - $2,262	51%
American Healthcare Alliance	$57 - $2,954	53%
Wellfit/Centrus	$76 - $2,259	71%
Centivo	$78 - $2,259	73%
Humana	$78 - $2,311	73%
Orscheln	$79 - $2,259	74%
Quiktrip	$80 - $2,262	75%
Nebraska Furniture Mart	$81 - $2,259	76%
Medica	$90 - $2,026	84%
Blue Cross Blue Shield	$100 - $2,572	94%
Multiplan	$100 - $2,641	94%
Aetna	$102 - $2,363	95%
Mercy Health	$113 - $2,606	106%
Coxhealth Network	$115 - $2,572	108%
Coventry Health Care Of Kansas	$130 - $2,572	122%
National Preferred Provider Network	$136 - $3,128	127%

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 $871.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
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.