CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Valley Children's Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $3,414
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 14.01x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Valley Children's Hospital is $3,414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.01x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,414

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%)
Insurance Median: $3,414 (1401%)
Ins. Median: $3,414 (1401% 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 1401% of the Medicare baseline (a markup of 1301%). 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.

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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
Allcare Ipa $174 71%
Dignity Ipa_Formerly Img $244 100%
La Salle Ipa $244 100%
Sante Ipa $244 100%
Kaiser $253 - $4,458 104%
Central Valley Medical Providers Ipa $261 - $3,430 107%
Sequoia Health Ipa $261 107%
Univseral Healthcare Ipa $261 107%
United Physicians Network Ipa $270 111%
Community Care Ipa $275 113%
Adventist $307 126%
Blue Cross Blue Shield $316 - $2,360 130%
UnitedHealthcare $331 - $844 136%
Cencal Health $345 142%
Kern Family Health Care $348 143%
Central California Alliance For Health $355 146%
Health Net $2,414 - $4,491 990%
Dignity Health Central Coast $3,399 1394%
Community Health $3,772 1547%
Stanislaus Partners In Health $3,772 1547%
Physicians Choice Medical Group $3,841 1576%
Health Plan Of San Joaquin $4,115 1688%
Fowler Packing $4,253 1745%
Dignity (Formerly Managed Care Systems) $4,321 1773%
Kern Legacy $4,458 1829%
Blue Shield $4,581 - $5,204 1879%
Aetna $4,596 1885%
First Health Formerly Coventry $5,076 2082%
Bakersfield Family Medical Group $5,144 2110%
Network By Design $5,316 2181%
Community Care Health Plan $5,485 2250%
Health Smart $5,487 2251%
Key Medical Ipa $5,487 2251%
Sutter Health $5,830 2392%
Multiplan $6,562 2692%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens