CMS Price Transparency Data
CT scan, sinuses
Facility: Mercy Hospital Logan County
Billing Code: 70486 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 70486
- Insurance Median: $1,000
- Cash Discount Price: $1,194
- vs. Medicare Baseline: 9.36x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Mercy Hospital Logan County is $1,000. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,194. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.36x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$1,194
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,000
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: $1,194 (1118%)
Insurance Median: $1,000 (936%)
Cash: $1,194 (1118% of Medicare)
Ins. Median: $1,000 (936% 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 936% of the Medicare baseline (a markup of 836%). 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.
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 | $76 - $1,178 | 71% |
| Humana | $76 - $512 | 71% |
| Medicaid / KanCare | $76 - $602 | 71% |
| Health Choice Contracted [320166] | $292 | 273% |
| Tricare | $413 - $498 | 387% |
| Blue Cross Blue Shield | $425 - $963 | 398% |
| Cherokee Nation Health Serv Contracted [320066] | $425 - $512 | 398% |
| Cross Timbers Hospice [20098] | $425 - $512 | 398% |
| Dept Of Veteran Affairs Contracted [320106] | $425 - $512 | 398% |
| Elara Caring Aspire Hospice Contracted [320433] | $425 - $512 | 398% |
| Elara Caring Aspire Hospice [20433] | $425 - $512 | 398% |
| Halo Hcr Inc Hospice Contracted [320432] | $425 - $512 | 398% |
| Halo Hcr Inc Hospice [20432] | $425 - $512 | 398% |
| Independent Health [20197] | $425 - $512 | 398% |
| Indian Health Service Contracted [320198] | $425 - $512 | 398% |
| Kindful Hospice Contracted [320434] | $425 - $512 | 398% |
| Kindful Hospice [20434] | $425 - $512 | 398% |
| Medical Associates Health [20444] | $425 - $512 | 398% |
| Medicare (plans) | $425 - $1,004 | 398% |
| Mercy Hospice Okc [20252] | $425 - $512 | 398% |
| Provider Partners Health Plans Contracted [320450] | $425 - $512 | 398% |
| Qual Choice Contracted [320325] | $425 - $512 | 398% |
| Tribute Health Plan Mcr Contracted [320338] | $425 - $512 | 398% |
| UnitedHealthcare | $425 - $1,405 | 398% |
| Globalhealth Contracted [320145] | $434 - $522 | 406% |
| Cigna | $438 - $1,706 | 410% |
| Ambetter / Centene | $500 - $602 | 468% |
| Home State Health Plan Contracted [320187] | $500 - $602 | 468% |
| Novasys Contracted [320285] | $500 - $602 | 468% |
| Webtpa Contracted [320417] | $700 - $843 | 655% |
| Medica Contracted [320239] | $834 - $1,004 | 781% |
| Aither Health Contracted [320449] | $1,000 - $1,706 | 936% |
| Auxiant Contracted [320462] | $1,000 - $1,706 | 936% |
| Federal Medical Center Contracted [320127] | $1,000 - $1,204 | 936% |
| Healthlink Contracted [320179] | $1,000 - $1,706 | 936% |
| Healthscope Contracted [320182] | $1,000 - $1,204 | 936% |
| Mercy Benefit Admin Contracted [320251] | $1,000 - $1,706 | 936% |
| Point C Contracted [320238] | $1,000 - $1,204 | 936% |
| Preferred Health Plan Contracted [320522] | $1,000 - $1,204 | 936% |
| Quik Trip Contracted [320447] | $1,000 - $1,204 | 936% |
| Show-Me Health Administrators Contracted [320483] | $1,000 - $1,204 | 936% |
| United Medical Resources Contracted [320454] | $1,000 - $1,405 | 936% |
| Osma Health Contracted [320292] | $1,167 - $1,405 | 1093% |
| United Behavioral Health Contracted [320390] | $1,167 - $1,405 | 1093% |
| Benefit Management Contracted [320052] | $1,250 - $1,806 | 1170% |
| Globalhealth Contracted [320144] | $1,250 - $1,505 | 1170% |
| Healthcare Highways Plus Contracted [320175] | $1,250 - $1,505 | 1170% |
| Private Health Care Systems Contracted [320320] | $1,250 - $1,606 | 1170% |
| First Health Contracted [320128] | $1,304 - $1,569 | 1221% |
| Multiplan Contracted [320270] | $1,334 - $1,806 | 1249% |
| Community Care Contracted [320080] | $1,366 | 1279% |
| Ebms Contracted [320493] | $1,417 - $1,706 | 1327% |
| Imagine 360 Contracted [320494] | $1,417 - $1,706 | 1327% |
| Preferred Community Choice Contracted [320311] | $1,417 - $1,706 | 1327% |
| Reflect Health Contracted [320492] | $1,417 - $1,706 | 1327% |
| Yuzu Health Contracted [320521] | $1,417 - $1,706 | 1327% |