CMS Price Transparency Data

CT scan, head (no contrast)

Facility: Monroe County Hospital

Billing Code: 70450 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70450
Insurance Median: $936
Cash Discount Price: $1,134
vs. Medicare Baseline: 8.76x Medicare

The contracted insurance negotiated median rate for a CT scan, head (no contrast) at Monroe County Hospital is $936. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,134. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.76x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$1,134

Average discount available for prompt cash payment at this facility.

Insurance Median

$936

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: $1,134 (1062%)

Insurance Median: $936 (876%)

Cash: $1,134 (1062% of Medicare)

Ins. Median: $936 (876% 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 876% of the Medicare baseline (a markup of 776%). 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
Wellmark Hmo	$414	388%
Wellmark Ppo - All Other Plans	$445	417%
Mahp Mcare - All Plans	$769 - $818	720%
Tricare	$769 - $818	720%
UnitedHealthcare	$769 - $1,850	720%
Va Ccn - All Plans	$769 - $818	720%
Amerigroup Mcare	$777 - $826	727%
Humana	$777 - $826	727%
Wellmark Mcare	$777 - $826	727%
Aetna	$785 - $1,830	735%
Iowa Total Care Mcaid - All Plans	$916 - $973	858%
Molina Mcaid - All Plans	$929 - $988	870%
Amerigroup Mcaid - All Other Plans	$943 - $1,002	883%
Centivo - All Plans	$1,154 - $1,227	1080%
Midlands Choice - All Plans	$1,282 - $1,363	1200%
Preferred Hlth - All Plans	$1,374 - $1,460	1286%
Geha - All Plans	$1,466 - $1,558	1373%
Multiplan - All Plans	$1,649 - $1,752	1544%
Integrated Hp - All Plans	$1,777 - $1,889	1664%

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 $1,134.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70450.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70450.
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.