CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $774
Cash Discount Price: $1,690
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Iowa Specialty Hospital - Clarion is $774. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,690. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.17x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$1,690

Average discount available for prompt cash payment at this facility.

Insurance Median

$774

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $1,690 (474%)

Insurance Median: $774 (217%)

Cash: $1,690 (474% of Medicare)

Ins. Median: $774 (217% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 217% of the Medicare baseline (a markup of 117%). 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	$80 - $1,663	22%
Triwest Va - All Plans	$80 - $1,663	22%
Aetna	$89 - $4,561	25%
Healthscope Stellar-All Plans	$132 - $2,833	37%
Health Partners Ish-All Other Plans	$153 - $4,293	43%
Wellmark Hmo	$166 - $877	47%
Auxiant Clarion Schools-All Plans	$174 - $3,488	49%
Wellmark Ppo - All Other Plans	$186 - $964	52%
Health Partners Prestage	$201 - $4,024	56%
UnitedHealthcare	$231 - $5,098	65%
Cigna	$671 - $5,205	188%
Midlands Choice-All Plans	$671 - $5,205	188%

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 $1,690.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

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 74177.
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.