CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Fairview Park Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $621
Cash Discount Price: $14,171
vs. Medicare Baseline: 2.55x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Fairview Park Hospital is $621. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,171. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.55x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$14,171

Average discount available for prompt cash payment at this facility.

Insurance Median

$621

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: $14,171 (5813%)

Insurance Median: $621 (255%)

Cash: $14,171 (5813% of Medicare)

Ins. Median: $621 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Blue Cross Blue Shield	$108 - $309	44%
Aetna	$212 - $7,812	87%
Health One Alliance	$213	87%
Core Resources	$218	89%
Ambetter / Centene	$285	117%
United	$518 - $6,377	212%
Prime Health	$608	249%
Employer'S Health Network	$621	255%
Rockport United Network	$621	255%
Identity Mco	$633	260%
Synergy Health Network	$633	260%
Amerigroup	$1,899	779%
Nhc Advantage	$2,692	1104%
Pruitt Health	$2,692	1104%
Peach State	$2,834	1163%
Wellcare	$2,834	1163%
Memorial Health Plan	$3,118	1279%
Americas 1St Choice	$3,968	1628%
Leavitt Risk Partners	$4,251	1744%
Dodge County Hospital	$7,086	2907%
American Steel Products	$12,045	4941%
City Of Eastman	$12,045	4941%
Dodge Co Board Of Commissioners	$12,045	4941%
Graham Brothers Construction	$12,045	4941%
Multiplan	$12,754	5232%
Novanet	$12,754	5232%

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 $14,171.
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 Fairview Park 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.