CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $9,161
  • Cash Discount Price: $29,551
  • vs. Medicare Baseline: 37.58x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Central Florida Lake Monroe Hospital is $9,161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29,551. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 37.58x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$29,551

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,161

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: $29,551 (12122%)
Insurance Median: $9,161 (3758%)
Cash: $29,551 (12122% of Medicare)
Ins. Median: $9,161 (3758% 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 3758% of the Medicare baseline (a markup of 3658%). 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.

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
United $518 - $13,298 212%
Aetna $1,186 - $8,865 487%
Avmed $1,695 - $14,775 695%
Freedom Health $2,128 873%
Optimum $2,128 873%
Corvel Corporation $3,903 1601%
Prime Health $3,986 1635%
Careworks (Rockport Community) $4,109 1686%
Simply $4,551 1867%
Molina Healthcare $5,615 - $9,456 2303%
Sunshine State Health Plan $7,535 3091%
Plotkin Health $14,775 6061%
Prime Health Sheriff $14,775 6061%
Multiplan $22,163 - $25,118 9092%
Three Rivers Provider Network $22,163 9092%
Ppo Next $25,118 10304%
Novanet $26,595 10910%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals