CMS Price Transparency Data
CT scan, abdomen and pelvis (no contrast)
Facility: Mercy Hospital Waldron
Billing Code: 74176 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74176
- Insurance Median: $980
- Cash Discount Price: $2,263
- vs. Medicare Baseline: 4.02x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Hospital Waldron is $980. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,263. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.02x the Medicare baseline. Located in 1341 West Sixth Street, Waldron, AR.
Cash / Self-Pay
$2,263
Average discount available for prompt cash payment at this facility.
Insurance Median
$980
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$243.77
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,263 (928%)
Insurance Median: $980 (402%)
Cash: $2,263 (928% of Medicare)
Ins. Median: $980 (402% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $243.77 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 402% of the Medicare baseline (a markup of 302%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $89 - $1,358 | 37% |
| Summit Community Care Contracted [320368] | $108 | 44% |
| Aetna | $162 - $2,263 | 66% |
| Humana | $162 - $2,959 | 66% |
| Novasys Contracted [320285] | $208 - $1,358 | 85% |
| Blue Cross Blue Shield | $224 - $956 | 92% |
| Usable Contracted [320409] | $224 | 92% |
| Arkansas Total Care Contracted [320039] | $246 | 101% |
| United Medical Resources Contracted [320454] | $524 | 215% |
| UnitedHealthcare | $524 - $956 | 215% |
| Qual Choice Contracted [320324] | $845 | 347% |
| Tricare | $940 | 386% |
| American Health Advantage Of Mo Mcr [20264] | $956 | 392% |
| Cherokee Nation Health Serv Contracted [320066] | $956 | 392% |
| Cross Timbers Hospice [20098] | $956 | 392% |
| Dept Of Veteran Affairs Contracted [320106] | $956 | 392% |
| Elara Caring Aspire Hospice Contracted [320433] | $956 | 392% |
| Elara Caring Aspire Hospice [20433] | $956 | 392% |
| Globalhealth Contracted [320145] | $956 | 392% |
| Halo Hcr Inc Hospice Contracted [320432] | $956 | 392% |
| Halo Hcr Inc Hospice [20432] | $956 | 392% |
| Independent Health [20197] | $956 | 392% |
| Indian Health Service Contracted [320198] | $956 | 392% |
| Indian Health Service [20198] | $956 | 392% |
| Jordan Valley Senior Care Pace [20515] | $956 | 392% |
| Kindful Hospice Contracted [320434] | $956 | 392% |
| Kindful Hospice [20434] | $956 | 392% |
| Medical Associates Health [20444] | $956 | 392% |
| Medicare (plans) | $956 - $1,004 | 392% |
| Mercy Hospice Okc [20252] | $956 | 392% |
| Pace Of The Ozarks [20518] | $956 | 392% |
| Provider Partners Health Plans Contracted [320450] | $956 | 392% |
| Qual Choice Contracted [320325] | $956 | 392% |
| Spina Bifida Hlthcare Benefit [20506] | $956 | 392% |
| Valir Pace [20503] | $956 | 392% |
| Cigna | $1,004 - $2,959 | 412% |
| Ambetter / Centene | $1,358 | 557% |
| Home State Health Plan Contracted [320187] | $1,358 | 557% |
| Mercy Interfacility [20513] | $1,549 | 635% |
| Auxiant Contracted [320462] | $2,089 - $3,133 | 857% |
| Mercy Benefit Admin Contracted [320251] | $2,089 - $3,133 | 857% |
| Workers Comp [20426] | $2,263 | 928% |
| 90 Degree Benefits Contracted [320436] | $2,959 | 1214% |
| Aither Health Contracted [320449] | $2,959 | 1214% |
| Ebms Contracted [320493] | $2,959 | 1214% |
| Edison Health Solutions Contracted [320502] | $2,959 | 1214% |
| Healthlink Contracted [320179] | $2,959 - $3,133 | 1214% |
| Imagine 360 Contracted [320494] | $2,959 | 1214% |
| Multiplan Contracted [320270] | $2,959 | 1214% |
| Multiplan [20270] | $2,959 | 1214% |
| Municipal Health Plan Contracted [320271] | $2,959 | 1214% |
| Reflect Health Contracted [320492] | $2,959 | 1214% |
| Show-Me Health Administrators Contracted [320483] | $2,959 | 1214% |
| Federal Medical Center Contracted [320127] | $3,133 | 1285% |
| Healthscope Contracted [320182] | $3,133 | 1285% |
| Insurance System Inc Contracted [320465] | $3,133 | 1285% |
| Personify Health Contracted [320051] | $3,133 | 1285% |
| Point C Contracted [320238] | $3,133 | 1285% |
| Preferred Health Plan Contracted [320522] | $3,133 | 1285% |
| Tri State Healthcare Coalition Contracted [320379] | $3,133 | 1285% |