CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: South Miami Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $4,217
Cash Discount Price: $5,878
vs. Medicare Baseline: 17.30x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at South Miami Hospital is $4,217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,878. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 17.30x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$5,878

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,217

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: $5,878 (2411%)

Insurance Median: $4,217 (1730%)

Cash: $5,878 (2411% of Medicare)

Ins. Median: $4,217 (1730% 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 1730% of the Medicare baseline (a markup of 1630%). 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
Amerigroup	$197	81%
Medicaid / KanCare	$197 - $217	81%
UnitedHealthcare	$207 - $9,568	85%
Wellcare	$207	85%
Sunshine State	$209	86%
Aetna	$213 - $7,654	87%
Vista	$213	87%
Medicare (plans)	$249 - $336	102%
Blue Cross Blue Shield	$258 - $6,200	106%
Medica Health Plan	$267	110%
Humana	$272	112%
Avmed	$274 - $4,736	112%
Leon Medical	$274	112%
Cigna	$284 - $7,654	117%
Non Contracted	$3,126 - $3,511	1282%
Amerihealth	$3,834 - $4,306	1573%
International	$5,537 - $6,219	2271%
Dimension Health Plan	$6,389 - $8,611	2621%
Affordable	$7,241 - $8,133	2970%
Phcs	$7,667 - $8,611	3145%
Quality Health	$7,667 - $8,611	3145%

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 $5,878.
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 South Miami Hospital 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.