CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Doctors Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $3,237
  • Cash Discount Price: $5,537
  • vs. Medicare Baseline: 13.28x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Doctors Hospital is $3,237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,537. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.28x the Medicare baseline. Located in 5000 University Dr, Coral Gables, FL.
Cash / Self-Pay
$5,537

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,237

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: $5,537 (2271%)
Insurance Median: $3,237 (1328%)
Cash: $5,537 (2271% of Medicare)
Ins. Median: $3,237 (1328% 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 1328% of the Medicare baseline (a markup of 1228%). 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
Amerigroup $197 81%
Medicaid / KanCare $197 - $217 81%
UnitedHealthcare $207 - $8,519 85%
Wellcare $207 85%
Sunshine State $209 86%
Aetna $213 - $6,815 87%
Vista $213 87%
Medicare (plans) $249 - $336 102%
Blue Cross Blue Shield $258 - $5,520 106%
Medica Health Plan $267 110%
Humana $272 112%
Avmed $274 - $4,217 112%
Leon Medical $279 114%
Cigna $284 - $6,815 117%
Non Contracted $3,126 1282%
Amerihealth $3,834 1573%
International $5,537 2271%
Dimension Health Plan $6,389 - $7,667 2621%
Affordable $7,241 2970%
Phcs $7,667 3145%
Quality Health $7,667 3145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 University Dr, Coral Gables, FL 33146
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals