CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $644
Cash Discount Price: $1,606
vs. Medicare Baseline: 2.64x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Iowa Specialty Hospital - Clarion is $644. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,606. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.64x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$1,606

Average discount available for prompt cash payment at this facility.

Insurance Median

$644

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,606 (659%)

Insurance Median: $644 (264%)

Cash: $1,606 (659% of Medicare)

Ins. Median: $644 (264% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 264% of the Medicare baseline (a markup of 164%). 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
Tricare	$76 - $1,565	31%
Triwest Va - All Plans	$76 - $1,565	31%
Aetna	$85 - $4,292	35%
Healthscope Stellar-All Plans	$126 - $2,666	52%
Health Partners Ish-All Other Plans	$147 - $4,039	60%
Wellmark Hmo	$158 - $877	65%
Wellmark Ppo - All Other Plans	$178 - $964	73%
Auxiant Clarion Schools-All Plans	$198 - $3,282	81%
UnitedHealthcare	$221 - $4,797	91%
Health Partners Prestage	$229 - $3,787	94%
Cigna	$410 - $4,898	168%
Midlands Choice-All Plans	$410 - $4,898	168%

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 $1,606.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74176.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Iowa Specialty Hospital - Clarion is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74176.
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.