CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Piedmont Walton Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $742
Cash Discount Price: $1,841
vs. Medicare Baseline: 3.04x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Piedmont Walton Hospital is $742. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,841. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.04x the Medicare baseline. Located in 2151 W Spring Street, Monroe, GA.

Cash / Self-Pay

$1,841

Average discount available for prompt cash payment at this facility.

Insurance Median

$742

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: $1,841 (755%)

Insurance Median: $742 (304%)

Cash: $1,841 (755% of Medicare)

Ins. Median: $742 (304% 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 304% of the Medicare baseline (a markup of 204%). 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
Cigna	$405 - $567	166%
Medicaid / KanCare	$550 - $578	226%
UnitedHealthcare	$584	240%
Alliant Health Plans Of Georgia [10952]	$742	304%
Aetna	$1,933	793%
First Health [10303]	$4,295	1762%
Novanet [10819]	$4,602	1888%
Multiplan [10600]	$4,909	2014%
Phcs [10601]	$4,909	2014%
Kaiser [10500]	$5,216	2140%
Beechstreet [10800]	$5,523	2266%

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 $1,841.
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 Piedmont Walton 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.