CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Veterans Memorial Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,018
Cash Discount Price: $966
vs. Medicare Baseline: 5.68x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Veterans Memorial Hospital is $1,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $966. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 5.68x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.

Cash / Self-Pay

$966

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,018

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: $966 (539%)

Insurance Median: $1,018 (568%)

Cash: $966 (539% of Medicare)

Ins. Median: $1,018 (568% 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 568% of the Medicare baseline (a markup of 468%). 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
Humana	$47 - $1,781	26%
Aetna	$56 - $1,586	31%
Amerigroup Mcr Adv	$56 - $1,021	31%
Iowa Total Care Exchange	$56 - $1,021	31%
Molina Mcr Adv	$56 - $1,021	31%
Quartz Mcr Adv	$56 - $1,021	31%
Welmark Mcr Adv	$56 - $1,021	31%
Quartz Comm - All Other Plans	$65 - $1,781	36%
Amerigroup Mcaid - All Other Plans	$179 - $1,014	100%
Wellmark Hmo - All Other Plans	$346	193%
Wellmark Ppo	$380	212%
Medica Comm - All Other Plans	$918	512%
Iowa Total Care Mcaid - All Other Plans	$1,014 - $1,211	566%
Molina Mcaid - All Other Plans	$1,014 - $1,211	566%
Iowa Total Care Mcr Adv	$1,021	570%
Medica Mcr Adv	$1,021	570%
UnitedHealthcare	$1,021 - $2,019	570%

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 $966.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Veterans Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
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.