CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Providence Santa Rosa Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $625
  • Cash Discount Price: $5,122
  • vs. Medicare Baseline: 2.56x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Providence Santa Rosa Memorial Hospital is $625. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,122. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.56x the Medicare baseline. Located in 1165 Montgomery Dr, Santa Rosa, CA.
Cash / Self-Pay
$5,122

Average discount available for prompt cash payment at this facility.

Insurance Median
$625

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: $5,122 (2101%)
Insurance Median: $625 (256%)
Cash: $5,122 (2101% of Medicare)
Ins. Median: $625 (256% 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 256% of the Medicare baseline (a markup of 156%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Healthnet $332 136%
Aetna $339 - $923 139%
UnitedHealthcare $373 153%
Blue Cross Blue Shield $877 - $1,259 360%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1165 Montgomery Dr, Santa Rosa, CA 95405
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals