CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Monroe County Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $1,672
Cash Discount Price: $2,027
vs. Medicare Baseline: 9.33x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Monroe County Hospital is $1,672. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,027. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 9.33x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$2,027

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,672

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: $2,027 (1131%)

Insurance Median: $1,672 (933%)

Cash: $2,027 (1131% of Medicare)

Ins. Median: $1,672 (933% 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 933% of the Medicare baseline (a markup of 833%). 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	231%
Wellmark Ppo - All Other Plans	$445	248%
Mahp Mcare - All Plans	$1,419	792%
Tricare	$1,419	792%
UnitedHealthcare	$1,419 - $3,209	792%
Va Ccn - All Plans	$1,419	792%
Amerigroup Mcare	$1,433	800%
Humana	$1,433	800%
Wellmark Mcare	$1,433	800%
Aetna	$1,447 - $3,175	807%
Iowa Total Care Mcaid - All Plans	$1,688	942%
Molina Mcaid - All Plans	$1,713	956%
Amerigroup Mcaid - All Other Plans	$1,738	970%
Centivo - All Plans	$2,128	1188%
Midlands Choice - All Plans	$2,365	1320%
Preferred Hlth - All Plans	$2,534	1414%
Geha - All Plans	$2,702	1508%
Multiplan - All Plans	$3,040	1696%
Integrated Hp - All Plans	$3,277	1829%

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 $2,027.
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 Monroe County 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.