CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Adventist Health Ukiah Valley

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $329
Cash Discount Price: $703
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Adventist Health Ukiah Valley is $329. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $703. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.35x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$703

Average discount available for prompt cash payment at this facility.

Insurance Median

$329

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: $703 (288%)

Insurance Median: $329 (135%)

Cash: $703 (288% of Medicare)

Ins. Median: $329 (135% 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

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
Cigna	$45 - $5,228	18%
Blue Shield Mcr Adv	$81 - $329	33%
Kaiser Mcr Adv	$81 - $329	33%
Tricare	$81 - $329	33%
Ah Employee Health Plan - All Plans	$89 - $592	37%
UnitedHealthcare	$108 - $5,603	44%
Healthnet-All Plans	$118 - $3,834	48%
Western Growers-All Plans	$120 - $2,815	49%
Aetna	$121 - $788	50%
Blue Shield Epn-All Other Plans	$150 - $920	62%
Blue Shield Non-Epn	$159 - $945	65%
Kaiser Medi-Cal	$174 - $257	71%
Medi-Cal	$174 - $257	71%
Mendocino Lcc District-All Plans	$210 - $3,500	86%
Kaiser-All Other Plans	$258 - $5,362	106%
Three Rivers-All Plans	$291 - $6,033	119%
Blue Cross Blue Shield	$570 - $761	234%
Foundation For Medical Care-All Plans	$5,027	2062%
Networks By Design-All Plans	$5,362	2200%
Phcs Multiplan-All Plans	$5,362	2200%
Interplan-All Plans	$5,496	2255%
Beech Street-All Plans	$5,698	2337%
Choice Care-All Plans	$5,698	2337%
Health Mgmt Network-All Plans	$5,698	2337%

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 $703.
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 Adventist Health Ukiah Valley 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.