CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Spencer Municipal Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,055
Cash Discount Price: $931
vs. Medicare Baseline: 5.89x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Spencer Municipal Hospital is $1,055. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $931. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.89x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.

Cash / Self-Pay

$931

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,055

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: $931 (520%)

Insurance Median: $1,055 (589%)

Cash: $931 (520% of Medicare)

Ins. Median: $1,055 (589% 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 589% of the Medicare baseline (a markup of 489%). 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
Medicare (plans)	$157 - $159	88%
UnitedHealthcare	$157 - $1,117	88%
Humana	$159 - $1,179	89%
Medicaid / KanCare	$176	98%
Wellmark Hmo	$910	508%
Healthpartners (All)	$993	554%
Wellmark Ppo	$999	557%
Midlands Choice - Ilcc	$1,055	589%
Midlands Choice - Morton Bldg	$1,055	589%
Coventry - Commercial Hmo	$1,117	623%
Avera Health Plan	$1,179	658%
Coventry - Commercial Ppo	$1,179	658%
First Choice Of Midwest	$1,179	658%
Midlands Choice (All Others)	$1,179	658%
Sanford Health	$1,179	658%

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 $931.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Spencer Municipal Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70460.
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.