CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Medstar Health Physical Therapy

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $872
Cash Discount Price: $872
vs. Medicare Baseline: 3.58x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Medstar Health Physical Therapy is $872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $872. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.58x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.

Cash / Self-Pay

$872

Average discount available for prompt cash payment at this facility.

Insurance Median

$872

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: $872 (358%)

Insurance Median: $872 (358%)

Cash: $872 (358% of Medicare)

Ins. Median: $872 (358% 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 358% of the Medicare baseline (a markup of 258%). 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	$231 - $257	95%
Carefirst Advantage Inc	$250	103%
Tricare	$254	104%
UnitedHealthcare	$254 - $1,073	104%
Health Care Service Corporation	$262	107%
Humana	$262	107%
Kaiser Permanente	$262 - $751	107%
Carefirst Blue Choice Inc	$657 - $858	270%
Jhhc	$872	358%
Pfc	$872	358%
Medstar Family Choice Inc	$952	391%
Cigna	$1,006	413%
Kaiser	$1,049	430%
First Health	$1,140	468%
Private Healthcare Systems (Phcs)	$1,140	468%

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 $872.
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 Medstar Health Physical Therapy 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.