CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Monroe County Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,473
Cash Discount Price: $1,786
vs. Medicare Baseline: 8.22x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Monroe County Hospital is $1,473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,786. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 8.22x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$1,786

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,473

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: $1,786 (997%)

Insurance Median: $1,473 (822%)

Cash: $1,786 (997% of Medicare)

Ins. Median: $1,473 (822% 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 822% of the Medicare baseline (a markup of 722%). 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	$1,250	698%
Tricare	$1,250	698%
UnitedHealthcare	$1,250 - $2,828	698%
Va Ccn - All Plans	$1,250	698%
Amerigroup Mcare	$1,263	705%
Humana	$1,263	705%
Wellmark Mcare	$1,263	705%
Aetna	$1,275 - $2,798	711%
Iowa Total Care Mcaid - All Plans	$1,488	830%
Molina Mcaid - All Plans	$1,510	843%
Amerigroup Mcaid - All Other Plans	$1,532	855%
Centivo - All Plans	$1,876	1047%
Midlands Choice - All Plans	$2,084	1163%
Preferred Hlth - All Plans	$2,233	1246%
Geha - All Plans	$2,382	1329%
Multiplan - All Plans	$2,679	1495%
Integrated Hp - All Plans	$2,888	1612%

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 $1,786.
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 Monroe County Hospital 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.