CMS Price Transparency Data
CT scan, abdomen and pelvis (no contrast)
Facility: San Antonio Regional Hospital
Billing Code: 74176 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74176
- Insurance Median: $479
- Cash Discount Price: $1,243
- vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at San Antonio Regional Hospital is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.96x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,243
Average discount available for prompt cash payment at this facility.
Insurance Median
$479
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: $1,243 (510%)
Insurance Median: $479 (196%)
Cash: $1,243 (510% of Medicare)
Ins. Median: $479 (196% 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.
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 |
|---|---|---|
| Medi-Cal | $257 | 105% |
| Kaiser Medi-Cal | $270 | 111% |
| Healthnet Medi-Cal | $271 | 111% |
| Alpha Care Mg Mcal/Hlthy Kids | $282 | 116% |
| Heritage Prov Ntwrk/Regal Mcal | $282 | 116% |
| Molina Medi-Cal | $295 | 121% |
| Tricare | $301 | 123% |
| Blue Cross Blue Shield | $303 - $8,370 | 124% |
| Blue Shield Mcr Adv | $307 | 126% |
| Caremore Mcr Adv - All Plans | $307 | 126% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $307 | 126% |
| Healthnet Mcr Adv | $307 | 126% |
| Humana | $307 | 126% |
| Iehp Mcr Adv | $307 | 126% |
| Inter Valley Hp Mcr Adv- All Plans | $307 | 126% |
| Kindred Mcr Adv-All Plans | $307 | 126% |
| Molina Mcr Adv | $307 | 126% |
| Scan Health Plan Mcr Adv-All Plans | $307 | 126% |
| Universal Care - All Plans | $307 | 126% |
| UnitedHealthcare | $316 - $1,345 | 130% |
| Zelis Mcr Adv | $322 | 132% |
| Kasiser Mcr Adv | $328 | 135% |
| Iehp Mcal | $334 | 137% |
| Aetna | $335 - $15,400 | 137% |
| Imperial Health Mcr Adv-All Plans | $338 | 139% |
| Pc Inland Valley Scan | $362 | 149% |
| Pc Inland Valley-All Other Plans | $362 | 149% |
| Choice Phycn Ntwrk Op Only | $384 | 158% |
| Molina Exchange-All Other Plans | $399 | 164% |
| Iehp Comm - All Other Plans | $445 | 183% |
| Redlands Employee | $460 | 189% |
| Redlands Hmo-All Other Plans | $479 | 196% |
| Prime Health - All Plans | $537 | 220% |
| Choicecare Ntwrk-All Plans | $550 | 226% |
| Healthnet - All Other Plans | $734 | 301% |
| Kaiser Comm - All Other Plans | $856 | 351% |
| Blue Shield Epn | $887 | 364% |
| Coventry Ccn/First Hlth - All Plans | $1,200 | 492% |
| Ambetter / Centene | $2,730 | 1120% |
| Blue Shield Epo Ppo - All Other Plans | $3,244 | 1331% |
| Blue Shield Hmo Pos / Calpers Ppo | $3,244 | 1331% |
| Epic Health Plan - All Other Plans | $4,620 | 1895% |
| Networks By Design - All Plans | $8,574 | 3517% |
| Multiplan/Phcs - All Plans | $11,088 | 4549% |
| Zelis Comm-All Other Plans | $11,550 | 4738% |
| Foundation Inland Epo-All Other Plans | $12,320 | 5054% |
| Foundation Inland Ppo | $13,090 | 5370% |
| Health Payors - All Plans | $13,860 | 5686% |
| Interplan - All Plans | $13,860 | 5686% |
| Wellcare/Easy Choice-All Plans | $15,092 | 6191% |
| Alpha Care Mg Mcr Adv | $15,400 | 6317% |
| Central Hlth Plan Mcr Adv-All Plans | $15,400 | 6317% |
| Epic Health Plan Mcr Adv | $15,400 | 6317% |
| Prospect Hp-All Plans | $15,400 | 6317% |
| Providence Clevercare Mcr Adv | $15,400 | 6317% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $15,631 | 6412% |
| Clever Care Mcr Adv - All Plans | $16,170 | 6633% |
| La Salle Hp Mcr Adv-All Plans | $16,170 | 6633% |
| Providence Oscar-All Other Plans | $16,170 | 6633% |
| Alpha Care Mg-All Other Plans | $19,250 | 7897% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $28,298 | 11608% |