CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Adventist Health Sierra Vista

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $4,818
Cash Discount Price: $1,178
vs. Medicare Baseline: 19.76x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Adventist Health Sierra Vista is $4,818. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,178. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 19.76x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$1,178

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,818

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: $1,178 (483%)

Insurance Median: $4,818 (1976%)

Cash: $1,178 (483% of Medicare)

Ins. Median: $4,818 (1976% 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 1976% of the Medicare baseline (a markup of 1876%). 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
Aetna	$306	126%
Cencal Mcr Adv - All Other Plans	$306	126%
Tricare	$306	126%
UnitedHealthcare	$306 - $4,504	126%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$398	163%
Ah Employee Health Plan - All Plans	$551	226%
Hpn-Heritage Prov Ntwrk-All Plans	$4,451	1826%
Blue Shield Epn	$5,132	2105%
Blue Shield Hmo/Pos	$6,389	2621%
Nbd-Ntwrks By Design Exclus-All Other Plans	$6,458	2649%
Blue Shield Epo/Ppo-All Other Plans	$7,044	2890%
Nbd-Ntwrks By Design Non-Exclus	$7,561	3102%
Medi-Cal	$13,092	5371%
Cencal Mcal	$14,925	6123%
Blue Shield Promise Mcal	$15,737	6456%
Ccah-Centrl Ca Allince Mcal-All Plans	$17,020	6982%
Coalinga-All Plans	$17,020	6982%

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 $1,178.
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 Sierra Vista 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.