CMS Price Transparency Data

CT scan, chest (no contrast)

Facility: Iowa Specialty Hospital - Belmond

Billing Code: 71250 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71250
Insurance Median: $327
Cash Discount Price: $700
vs. Medicare Baseline: 3.06x Medicare

The contracted insurance negotiated median rate for a CT scan, chest (no contrast) at Iowa Specialty Hospital - Belmond is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $700. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.06x the Medicare baseline. Located in 403 First Street Se, Belmond, IA.

Cash / Self-Pay

$700

Average discount available for prompt cash payment at this facility.

Insurance Median

$327

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: $700 (655%)

Insurance Median: $327 (306%)

Cash: $700 (655% of Medicare)

Ins. Median: $327 (306% 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 306% of the Medicare baseline (a markup of 206%). 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	$47 - $1,978	44%
Tricare	$47 - $666	44%
Triwest Va Choice And Pc3-All Plans	$47 - $666	44%
UnitedHealthcare	$47 - $1,822	44%
Healthscope Stellar - All Plans	$78 - $1,099	73%
Health Partners Ish-All Other Plans	$88 - $1,666	82%
Wellmark Hmo	$105 - $329	98%
Wellmark Ppo-All Other Plans	$118 - $362	110%
Auxiant Clarion Schools-All Plans	$163 - $1,353	153%
Health Partners Prestage	$188 - $1,562	176%
Cigna	$324 - $2,020	303%
Midlands Choice-All Plans	$324 - $2,020	303%

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 $700.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71250.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Iowa Specialty Hospital - Belmond is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71250.
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.