CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Grossmont Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,900
Cash Discount Price: $3,480
vs. Medicare Baseline: 11.90x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Grossmont Hospital is $2,900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,480. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.90x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$3,480

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,900

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: $3,480 (1428%)

Insurance Median: $2,900 (1190%)

Cash: $3,480 (1428% of Medicare)

Ins. Median: $2,900 (1190% 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 1190% of the Medicare baseline (a markup of 1090%). 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
San Diego Pace	$812	333%
Community Health Group	$1,378 - $2,584	565%
Epic Americas	$1,378	565%
Aetna	$1,392 - $3,155	571%
California Health And Wellness	$1,822 - $2,320	747%
Health Net	$2,223 - $4,547	912%
UnitedHealthcare	$2,223 - $2,830	912%
Blue Cross Blue Shield	$2,227 - $3,248	914%
Allianz Global Assistance	$2,552 - $2,960	1047%
Cigna	$2,622 - $2,900	1076%
Humana	$2,830	1161%
Kaiser	$2,900	1190%
Blue Shield	$3,155 - $3,805	1294%
County Medical Services	$3,155 - $3,248	1294%
Managed Health Network	$3,202	1314%
Medicare (plans)	$3,248	1332%
Medi-Cal	$3,805	1561%
Molina	$3,805	1561%

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 $3,480.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74176.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74176.
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.