CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Mercy Hospital Ada

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,226
Cash Discount Price: $1,967
vs. Medicare Baseline: 6.84x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Mercy Hospital Ada is $1,226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,967. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 6.84x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$1,967

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,226

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: $1,967 (1098%)

Insurance Median: $1,226 (684%)

Cash: $1,967 (1098% of Medicare)

Ins. Median: $1,226 (684% 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 684% of the Medicare baseline (a markup of 584%). 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 - $2,276	55%
Humana	$99 - $181	55%
Medicaid / KanCare	$99 - $245	55%
Blue Cross Blue Shield	$178	99%
Cherokee Nation Health Serv Contracted [320066]	$178	99%
Cross Timbers Hospice [20098]	$178	99%
Dept Of Veteran Affairs Contracted [320106]	$178	99%
Elara Caring Aspire Hospice Contracted [320433]	$178	99%
Elara Caring Aspire Hospice [20433]	$178	99%
Halo Hcr Inc Hospice Contracted [320432]	$178	99%
Halo Hcr Inc Hospice [20432]	$178	99%
Independent Health [20197]	$178	99%
Indian Health Service Contracted [320198]	$178	99%
Kindful Hospice Contracted [320434]	$178	99%
Kindful Hospice [20434]	$178	99%
Medical Associates Health [20444]	$178	99%
Medicare (plans)	$178 - $3,026	99%
Mercy Hospice Okc [20252]	$178	99%
Provider Partners Health Plans Contracted [320450]	$178	99%
Qual Choice Contracted [320325]	$178	99%
Tricare	$178	99%
UnitedHealthcare	$178 - $310	99%
Globalhealth Contracted [320145]	$182	102%
Cigna	$183	102%
Ambetter / Centene	$245	137%
Home State Health Plan Contracted [320187]	$245	137%
Novasys Contracted [320285]	$245	137%
Workers Comp [20426]	$306	171%
United Medical Resources Contracted [320454]	$310 - $1,816	173%
Healthsmart Preferred Care Contracted [320184]	$400	223%
Kempton Contracted [320214]	$400	223%
Medica Contracted [320239]	$439 - $3,026	245%
Health Choice Contracted [320166]	$490	273%
Healthcare Highways Plus Contracted [320175]	$1,180 - $2,270	658%
Webtpa Contracted [320417]	$1,271	709%
Osma Health Contracted [320292]	$1,362	760%
Benefit Management Contracted [320052]	$1,513 - $1,967	844%
Aither Health Contracted [320449]	$1,816	1013%
Auxiant Contracted [320462]	$1,816	1013%
Ebms Contracted [320493]	$1,816	1013%
Federal Medical Center Contracted [320127]	$1,816	1013%
Healthlink Contracted [320179]	$1,816	1013%
Healthscope Contracted [320182]	$1,816	1013%
Imagine 360 Contracted [320494]	$1,816	1013%
Mercy Benefit Admin Contracted [320251]	$1,816 - $1,967	1013%
Point C Contracted [320238]	$1,816	1013%
Preferred Health Plan Contracted [320522]	$1,816	1013%
Quik Trip Contracted [320447]	$1,816	1013%
Reflect Health Contracted [320492]	$1,816	1013%
Show-Me Health Administrators Contracted [320483]	$1,816	1013%
Yuzu Health Contracted [320521]	$1,816	1013%
Globalhealth Contracted [320144]	$1,906	1064%
First Health Contracted [320128]	$2,515	1403%
Multiplan Contracted [320270]	$2,572	1435%
Private Health Care Systems Contracted [320320]	$2,572	1435%

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 $1,967.
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 Ada 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.