Health Iowa

08/29/2026

08/19/2026

UnityPoint Hospitals charge uninsured Iowans dramatically different prices for the same CT scan.

08/19/2026

Same CT Scan. Same Health System. Prices from $1,634 to $4,886. How Does This Make Sense?

UnityPoint Health Appears to Take Advantage of the Uninsured

Imagine walking into a hospital for a routine CT scan of the abdomen and pelvis. You are uninsured, so there is no insurance company negotiating on your behalf. You are paying with your own money.

Now imagine discovering that the price for the exact same procedure — CPT 74176 — can vary by more than $3,200 among hospitals within the UnityPoint Health system and affiliated network.

That isn’t a hypothetical. Those are the self-pay prices published through UnityPoint Health’s price-transparency information.

Here is what an uninsured patient can face for CT Abdomen and Pelvis, CPT 74176:

Buchanan County Health Center: $3,496

Clarke County Hospital: $1,648

Greater Regional Health: $1,782

Humboldt County Memorial Hospital: $2,700

Buena Vista Regional Medical Center:$2,201

Greene County Medical Center: $1,795

Grundy County Memorial Hospital: $2,224

Lucas County Health Center: $3,660

Reedsburg Area Medical Center:$1,634

Lutheran Hospital:$4,886

Methodist West: $4,886

Marshalltown Medical Center: $2,149

Allen Memorial Hospital: $2,149

Source: UnityPoint Health website and hospital price-transparency information.

The lowest price is $1,634. The highest is $4,886.

That’s a $3,252 difference — nearly three times the price — for the same CPT code.

And remember who we are talking about: the uninsured patient paying the bill with his or her own money.

What Exactly Is the Patient Buying for the Extra $3,252?
That is the obvious question.

Does the $4,886 CT scan produce an image three times clearer than the $1,634 CT scan?

Does the CT scanner provide three times the diagnostic value?

Does the patient receive three times the healthcare?

Of course not.

Hospitals can legitimately have different operating costs, equipment, staffing expenses and patient populations. UnityPoint itself says hospital charges can vary because of technology, government funding, demographics and local or regional factors.

But a nearly 300% difference deserves considerably more explanation than simply saying hospitals have different costs.

UnityPoint describes itself as a network serving communities throughout Iowa, Illinois and Wisconsin. It also tells patients that knowing healthcare costs in advance is important and provides price-estimation resources for CT scans and other services.

That’s good.

But transparency shouldn’t merely allow us to discover irrational prices. Transparency should force healthcare organizations to explain them.

The People With the Least Protection Can Face the Biggest Problem
There is something particularly troubling about healthcare pricing when the person without an insurance card must navigate a system containing enormous price differences.

An insured patient has an insurance company negotiating rates. A large employer may have consultants, benefit administrators and claims data.

The uninsured patient has a wallet.

UnityPoint does offer financial assistance and encourages uninsured patients who need help to contact its financial counselors. That assistance is important.

But financial assistance doesn’t answer the fundamental pricing question:

Why should one hospital’s self-pay price for CPT 74176 be $1,634 while another’s is $4,886?

If $1,634 is economically reasonable at one hospital, what makes $4,886 reasonable somewhere else?

Patients deserve an understandable answer.

Try This Pricing Model Anywhere Else
Imagine three gas stations operating under the same broad organization.

One charges $3.25 per gallon.

Another charges $5.50.

The third charges $9.70.

Consumers would immediately ask what was going on.

Healthcare has conditioned Americans to accept pricing behavior they would consider absurd in virtually every other part of the economy.

Interestingly, UnityPoint itself acknowledged this problem years ago. In comments about healthcare price transparency, UnityPoint wrote that providers set prices at very high levels that permit large write-offs and stated plainly:

“Prices do not reflect costs.”

That statement should be remembered.

Because if prices do not reflect costs, what exactly determines what an uninsured patient is asked to pay?

Price Transparency Is Beginning to Expose the System
This is precisely why the federal Hospital Price Transparency requirements matter.

UnityPoint’s own website explains that CMS requires hospitals to publish machine-readable files containing pricing information, including payer information, for hospital items and services.

For decades, healthcare prices were largely hidden.

Now we can compare them.

And once consumers start comparing them, uncomfortable questions emerge.

Why does this CT cost $1,634 here and $4,886 there?

Who establishes these self-pay prices?

What methodology is used?

How frequently are they reviewed?

And perhaps most importantly:

Would the executives who establish these prices consider a nearly threefold variation reasonable if they were personally uninsured and writing the check?

Healthcare isn’t a normal consumer purchase. A patient needing an abdominal CT may be frightened, sick or worried about cancer, internal bleeding or another serious condition. That patient should be focused on getting appropriate medical care — not deciphering a pricing system where traveling to another hospital can potentially mean thousands of dollars in difference.

Now patients, employers, journalists and policymakers need to start using it.

Because publishing absurd prices doesn’t make those prices reasonable.

It simply makes the absurdity visible.

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08/16/2026

Three Dramatically Different Prices:

Same Scan
Same Hospital
Same Technician

County-Owned Hospital is Screwing the Uninsured Who Self-Pay

Why is that ok?

07/20/2026

As I thought about the biblical principles of truth, justice, compassion, stewardship, and loving our neighbor, I found myself remembering my very first W-2 job.

I had delivered newspapers since I was about 12 years old, but my first payroll job was at a Catholic hospital in the Central Supply Department. Years later, the department would receive the more sophisticated title of SPD—Supply, Processing and Distribution—but regardless of the name, my job was to help ensure physicians and nurses had the sterile instruments and supplies they needed to care for patients.

Even as a young employee, I learned something that has stayed with me for decades.

One of my favorite floors in the hospital was the OB-GYN unit. It wasn’t because of the work itself—it was because of the people.

A small woman in stature, but enormous in presence, oversaw that department. Her name was Sister Zita.

She had a remarkable way of making everyone feel cared for. Expectant mothers who were nervous about childbirth. Fathers anxiously pacing the hallways. Obstetricians moving quickly from one patient to the next. Nurses working long, exhausting shifts. Sister Zita seemed to know exactly what each person needed.

She wasn’t loud or dramatic. She simply embodied compassion.

Looking back, I don’t believe that was accidental.

The hospital’s religious foundation wasn’t just something written in its mission statement. It influenced how people treated one another. Patients weren’t viewed merely as admissions or procedures. They were people created in God’s image, deserving of dignity, kindness, honesty, and genuine concern.

Of course, hospitals today are far more complex than they were decades ago. Medicine has advanced. Technology has transformed care. Regulations have multiplied. Financial pressures have increased.

But I’ve often wondered whether we’ve lost something important along the way.

That memory came rushing back recently after an experience that genuinely surprised me.

An organization that identifies itself as being dedicated to patient and healthcare advocacy declined to publish a simple educational resource.

The resource wasn’t political.

It wasn’t critical of physicians or hospitals.

It wasn’t promoting legislation.

It wasn’t asking patients to argue with their doctors.

It simply presented ten practical questions that patients could respectfully ask their healthcare providers—questions about expected costs, available alternatives, financial assistance, medical necessity, and other information that could help families make informed decisions during what is often a stressful and emotional time.

In my view, it was exactly the kind of practical information patient advocates should welcome.

The reason it was declined had nothing to do with the questions themselves.

The concern was that each question included a corresponding Bible verse—not as an attempt to persuade anyone to adopt Christianity, nor to suggest that one political position is more “biblical” than another, but simply to explain the principle behind the question.

A question about honest pricing referenced Scripture’s call to speak truthfully.

A question about treating every patient fairly pointed to verses about justice.

A question about helping patients facing financial hardship reflected biblical compassion.

A question encouraging patients to make informed decisions highlighted stewardship.

A question asking providers to treat patients as they would treat their own family reflected Jesus’ command to love our neighbor.

That was it.

There was no proselytizing.

No condemnation.

No claim that Christians possess all the answers to healthcare policy.

No suggestion that Scripture dictates a specific healthcare financing model.

Only the observation that many of the values Christians seek to practice in everyday life—truthfulness, fairness, compassion, wise stewardship, and love for others—also happen to be values that can improve the healthcare experience for everyone.

I couldn’t help but think back to Sister Zita.

I suspect she would not have been troubled by patients asking respectful questions. In fact, I imagine she would have encouraged them.

Because asking questions isn’t about challenging authority.

It’s about understanding.

It’s about helping families make informed decisions.

It’s about building trust through honest conversation.

And perhaps most importantly, it’s about recognizing that every patient sitting in an exam room or hospital bed is more than a diagnosis or an insurance card. They are a human being, often frightened, often uncertain, and deserving of both excellent medical care and honest answers.

Healthcare will always involve difficult decisions. Christians can—and do—hold different views about how healthcare should be organized and financed. But regardless of those differences, it seems difficult to argue against encouraging patients to ask thoughtful questions and expecting transparent, compassionate responses.

Those aren’t merely good healthcare practices.

They’re values that have stood the test of time.

Sister Zita knew what mattered.

Patient & Healthcare Advocacy - News, Tips & More!

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07/04/2026

Iowa’s water is dangerous:

Research suggests that long-term exposure to nitrate concentrations below the current federal standard (10 mg/L) may be associated with higher risks of:
Colorectal cancer;
Thyroid disease;
Adverse pregnancy outcomes;
Other chronic health conditions.

06/25/2026

MercyOne Des Moines Medical Center
Iowa Hospital Association
UnityPoint Health - Des Moines
Broadlawns Medical Center

06/18/2026

Iowa Hospital Price Transparency Compliance Report: A Troubling Pattern of Non-Compliance

And the Steps You Can Take to Make Hospital Price Transparency an Election Year Issue

The Iowa Hospital Price Transparency Compliance Report reveals a significant and widespread failure by Iowa hospitals to comply with federal hospital price transparency requirements. The report evaluated dozens of Iowa hospitals against federal standards requiring hospitals to publicly disclose prices, negotiated rates, cash prices, and consumer-friendly tools that allow patients to estimate healthcare costs before receiving care.

Key Finding: More Hospitals Were Non-Compliant Than Compliant

A review of the report shows that a majority of the hospitals evaluated were found to be non-compliant with one or more federal transparency requirements. Many of Iowa’s largest and most recognizable health systems were cited for deficiencies.

Examples of Non-Compliant Hospitals
Among the hospitals identified as non-compliant were:

• Broadlawns Medical Center (Des Moines)

Machine-readable file did not conform to federal requirements.

Required transparency link missing from hospital homepage.

Required website file deficiencies.

• University of Iowa Health Care Medical Center (Iowa City)

Machine-readable file did not conform to required standards.

Public website failed to properly host required transparency files.

• Methodist West Hospital (West Des Moines)

Machine-readable file failed to conform to federal requirements.

• CHI Health Mercy Hospital (Council Bluffs)

Price Estimator Tool failed to provide cash prices to consumers.

• MercyOne Des Moines Medical Center

Failed to include all payer and plan names.

Failed to properly disclose negotiated rate information.

• MercyOne West Des Moines Medical Center

Failed to include all payer and plan names.

Failed to properly disclose pricing information in the required format.

• MercyOne North Iowa (Mason City)

Failed to include all payer and plan names.

Failed to properly disclose negotiated charge information.

• Orange City Area Health System

Incomplete or inaccurate pricing information.

Failed to include all payer and plan names.

• UnityPoint Health Blank Children’s Hospital

Transparency website failed to properly host required files.

The report also identified numerous additional MercyOne facilities, community hospitals, and regional hospitals with similar deficiencies.

Common Compliance Failures
The most common violations included:

• Missing or incomplete machine-readable files.
• Failure to disclose all payer and health plan names.
• Failure to disclose minimum and maximum negotiated rates.
• Missing cash prices.
• Broken or missing transparency links.
• Non-compliant file formats.
• Price estimator tools that failed to provide consumer cash prices.
• Missing required website files needed for public access.

Why This Matters to Iowa Consumers
Hospital price transparency is not a paperwork exercise. It is a consumer protection law designed to help patients make informed healthcare purchasing decisions.

When hospitals fail to disclose prices:

• Patients cannot compare prices between hospitals.
• Patients cannot determine whether a cash price may be less expensive than using insurance.
• Employers cannot evaluate healthcare spending.
• Physicians cannot help patients identify affordable care options.
• Families are left making healthcare decisions without knowing the financial consequences.

The impact is particularly severe for high-deductible health plan members and self-pay patients.

Millions of Americans now have deductibles ranging from $2,000 to $10,000 or more. Until that deductible is met, patients are effectively spending their own money. Without transparent pricing, these consumers are unable to shop for healthcare services in a meaningful way.

Likewise, uninsured and self-pay patients depend on transparent pricing to avoid surprise bills and compare costs before receiving treatment.

The Negative Impact on Employers
Hospital price transparency was also intended to help employers, who sponsor health insurance coverage for millions of Americans and spend billions of dollars annually on healthcare benefits.

When hospitals fail to disclose prices:

• Employers lose the ability to identify lower-cost providers.
• Healthcare costs continue to rise without competitive market pressure.
• Insurance premiums increase.
• Employee payroll deductions increase.
• Wage growth is suppressed as more compensation dollars are redirected toward healthcare costs.
• Small businesses become less competitive.

Ultimately, hospital non-compliance impacts not only patients but also Iowa employers, employees, taxpayers, and the broader economy.

The Real Consequence: Delayed or Foregone Care
Perhaps the most damaging consequence of hospital non-compliance is that consumers often postpone or avoid needed medical treatment because they fear unknown costs.

When patients do not know whether a CT scan will cost $300 or $3,000, or whether a procedure will cost $2,000 or $20,000, many simply delay care. Some never receive the recommended test or treatment at all.

That uncertainty can lead to:

• Delayed diagnoses.
• Worsening medical conditions.
• Increased emergency room utilization.
• Higher long-term healthcare costs.
• Worse patient outcomes.

Federal hospital price transparency regulations were intended to eliminate this uncertainty. When hospitals fail to comply, consumers are denied the information necessary to make prudent healthcare decisions, particularly when they are spending their own money through high deductibles, health savings accounts, or self-pay arrangements.

Call to Action
2026 is an election year. Iowa voters will elect representatives for all four U.S. Congressional Districts and one U.S. Senate seat. Healthcare affordability consistently ranks among the top concerns of Iowa families, employers, and taxpayers.

Citizens should ask every candidate seeking federal office:

• Do you believe hospitals should comply with federal hospital price transparency laws?
• Do you support stronger enforcement against hospitals that repeatedly violate these requirements?
• Should hospitals receiving Medicare and Medicaid funding be required to fully disclose prices?
• What specific actions will you take to improve transparency and accountability if elected?
• How can consumers shop for healthcare if hospitals refuse to disclose prices?
• How can employers control healthcare costs when hospitals withhold pricing information?

Candidates frequently discuss making healthcare more affordable. Voters should ask whether they support enforcing one of the few existing laws specifically designed to empower healthcare consumers.

Sample Letter to the Editor
As Iowa enters another election season, voters should ask every candidate seeking to represent us in Washington a simple question:

Do you believe Iowa hospitals should comply with federal hospital price transparency laws, and if elected, what will you do to ensure they do?

A recent Iowa Hospital Price Transparency Compliance Report found that a substantial number of Iowa hospitals were not fully complying with federal requirements intended to help patients understand healthcare prices before receiving care.

This matters because today’s healthcare system increasingly shifts costs onto patients. Millions of Americans are enrolled in high-deductible health plans and are responsible for thousands of dollars of healthcare expenses before insurance begins paying. Self-pay patients face similar challenges.

When hospitals fail to disclose prices, consumers cannot compare costs, cannot budget, and often cannot determine whether a lower-cost option exists.

The result is predictable: many patients delay or avoid medical care because they fear receiving a bill they cannot afford.

The damage extends beyond patients.

Employers sponsor health insurance coverage for millions of Americans and spend billions of dollars annually on healthcare benefits. When hospitals withhold pricing information, employers lose an important tool for controlling healthcare costs. Those higher costs ultimately show up as higher premiums, lower wage growth, increased employee contributions, and reduced business competitiveness.

Hospital non-compliance hurts patients, families, employers, and taxpayers alike.

This should not be a partisan issue. Transparency is a basic consumer right.

I encourage Iowa voters to ask every candidate running for Iowa’s four Congressional seats and the U.S. Senate where they stand on hospital price transparency and what actions they will take to enforce compliance.

Healthcare affordability continues to rank among the top concerns of Iowa families. Transparency alone will not solve every healthcare problem, but consumers cannot make informed decisions when hospitals refuse to disclose prices.

If elected officials are serious about making healthcare more affordable, enforcing existing transparency laws would be an excellent place to start.

Sincerely,

[Your Name]
[City], State

Iowa Hospital Association
UnityPoint Health - Des Moines
MercyOne Des Moines Medical Center
Taxpayers Association of Central Iowa

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06/12/2026