CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $537
Cash Discount Price: $792
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Iowa Specialty Hospital - Clarion is $537. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $792. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 3.00x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$792

Average discount available for prompt cash payment at this facility.

Insurance Median

$537

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: $792 (442%)

Insurance Median: $537 (300%)

Cash: $792 (442% of Medicare)

Ins. Median: $537 (300% 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 300% of the Medicare baseline (a markup of 200%). 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	$50 - $740	28%
Triwest Va - All Plans	$50 - $740	28%
Aetna	$55 - $2,030	31%
Healthscope Stellar-All Plans	$82 - $1,261	46%
Health Partners Ish-All Other Plans	$96 - $1,910	54%
Wellmark Hmo	$102 - $877	57%
Wellmark Ppo - All Other Plans	$115 - $964	64%
UnitedHealthcare	$144 - $2,269	80%
Auxiant Clarion Schools-All Plans	$164 - $1,552	92%
Health Partners Prestage	$189 - $1,791	105%
Cigna	$335 - $2,316	187%
Midlands Choice-All Plans	$335 - $2,316	187%

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 $792.
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 Iowa Specialty Hospital - Clarion 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.