CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Spencer Municipal Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70470
  • Insurance Median: $845
  • Cash Discount Price: $704
  • vs. Medicare Baseline: 4.72x Medicare
The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Spencer Municipal Hospital is $845. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $704. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 4.72x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$704

Average discount available for prompt cash payment at this facility.

Insurance Median
$845

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: $704 (393%)
Insurance Median: $845 (472%)
Cash: $704 (393% of Medicare)
Ins. Median: $845 (472% 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 472% of the Medicare baseline (a markup of 372%). 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
Medicare (plans) $157 - $159 88%
UnitedHealthcare $157 - $845 88%
Humana $159 - $892 89%
Medicaid / KanCare $176 98%
Healthpartners (All) $751 419%
Midlands Choice - Ilcc $798 445%
Midlands Choice - Morton Bldg $798 445%
Coventry - Commercial Hmo $845 472%
Avera Health Plan $892 498%
Coventry - Commercial Ppo $892 498%
First Choice Of Midwest $892 498%
Midlands Choice (All Others) $892 498%
Sanford Health $892 498%
Wellmark Hmo $910 508%
Wellmark Ppo $999 557%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals