CMS Price Transparency Data
CT scan, sinuses
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $1,621
- Cash Discount Price: $1,963
- vs. Medicare Baseline: 15.18x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital Ardmore, Inc is $1,621. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,963. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.18x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$1,963
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,621
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: $1,963 (1838%)
Insurance Median: $1,621 (1518%)
Cash: $1,963 (1838% of Medicare)
Ins. Median: $1,621 (1518% 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 1518% of the Medicare baseline (a markup of 1418%). 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 |
|---|---|---|
| Aetna | $76 - $2,124 | 71% |
| Humana | $76 - $2,305 | 71% |
| Medicaid / KanCare | $76 - $146 | 71% |
| Blue Cross Blue Shield | $106 | 99% |
| Cherokee Nation Health Serv Contracted [320066] | $106 | 99% |
| Cross Timbers Hospice [20098] | $106 | 99% |
| Dept Of Veteran Affairs Contracted [320106] | $106 | 99% |
| Elara Caring Aspire Hospice Contracted [320433] | $106 | 99% |
| Elara Caring Aspire Hospice [20433] | $106 | 99% |
| Halo Hcr Inc Hospice Contracted [320432] | $106 | 99% |
| Halo Hcr Inc Hospice [20432] | $106 | 99% |
| Independent Health [20197] | $106 | 99% |
| Indian Health Service Contracted [320198] | $106 | 99% |
| Kindful Hospice Contracted [320434] | $106 | 99% |
| Kindful Hospice [20434] | $106 | 99% |
| Medical Associates Health [20444] | $106 | 99% |
| Medicare (plans) | $106 - $3,340 | 99% |
| Mercy Hospice Okc [20252] | $106 | 99% |
| Provider Partners Health Plans Contracted [320450] | $106 | 99% |
| Qual Choice Contracted [320325] | $106 | 99% |
| Tribute Health Plan Mcr Contracted [320338] | $106 | 99% |
| Tricare | $106 | 99% |
| Globalhealth Contracted [320145] | $108 | 101% |
| UnitedHealthcare | $108 - $851 | 101% |
| Cigna | $110 - $410 | 103% |
| Administrative Payor Contracted [320005] | $137 | 128% |
| Ambetter / Centene | $146 | 137% |
| Home State Health Plan Contracted [320187] | $146 | 137% |
| Novasys Contracted [320285] | $146 | 137% |
| Community Care Contracted [320080] | $162 - $2,338 | 152% |
| Workers Comp [20426] | $183 | 171% |
| Healthsmart Preferred Care Contracted [320184] | $239 - $2,171 | 224% |
| Kempton Contracted [320214] | $239 | 224% |
| Health Choice Contracted [320166] | $292 | 273% |
| Medica Contracted [320239] | $439 - $3,340 | 411% |
| Globalhealth Contracted [320144] | $470 | 440% |
| United Medical Resources Contracted [320454] | $851 - $2,171 | 797% |
| Healthcare Highways Plus Contracted [320175] | $1,053 - $2,004 | 986% |
| Webtpa Contracted [320417] | $1,134 - $1,403 | 1062% |
| Osma Health Contracted [320292] | $1,215 - $1,503 | 1138% |
| Aither Health Contracted [320449] | $1,621 - $2,004 | 1518% |
| Auxiant Contracted [320462] | $1,621 - $2,171 | 1518% |
| Benefit Management Contracted [320052] | $1,621 - $2,171 | 1518% |
| Ebms Contracted [320493] | $1,621 - $2,004 | 1518% |
| Healthlink Contracted [320179] | $1,621 - $2,171 | 1518% |
| Imagine 360 Contracted [320494] | $1,621 - $2,004 | 1518% |
| Mercy Benefit Admin Contracted [320251] | $1,621 - $2,171 | 1518% |
| Quik Trip Contracted [320447] | $1,621 - $2,004 | 1518% |
| Reflect Health Contracted [320492] | $1,621 - $2,004 | 1518% |
| Show-Me Health Administrators Contracted [320483] | $1,621 - $2,004 | 1518% |
| Yuzu Health Contracted [320521] | $1,621 - $2,004 | 1518% |
| Federal Medical Center Contracted [320127] | $1,756 - $2,171 | 1644% |
| Healthscope Contracted [320182] | $1,756 - $2,171 | 1644% |
| Healthsmart Accel Contracted [320183] | $1,756 - $2,171 | 1644% |
| Point C Contracted [320238] | $1,756 - $2,171 | 1644% |
| Preferred Health Plan Contracted [320522] | $1,756 - $2,171 | 1644% |
| Tri State Healthcare Coalition Contracted [320379] | $1,756 - $2,171 | 1644% |
| First Health Contracted [320128] | $1,796 - $2,221 | 1681% |
| Private Health Care Systems Contracted [320320] | $2,026 - $2,672 | 1897% |
| Preferred Community Choice Contracted [320311] | $2,053 - $2,538 | 1922% |
| Multiplan Contracted [320270] | $2,161 - $3,006 | 2023% |