CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: St Marys Good Samaritan Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $453
  • Cash Discount Price: $1,090
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at St Marys Good Samaritan Hospital is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,090. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.86x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.
Cash / Self-Pay
$1,090

Average discount available for prompt cash payment at this facility.

Insurance Median
$453

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: $1,090 (447%)
Insurance Median: $453 (186%)
Cash: $1,090 (447% of Medicare)
Ins. Median: $453 (186% 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.

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
Peach State $189 78%
Wellcare $189 - $453 78%
Blue Cross Blue Shield $324 - $1,212 133%
Aetna $453 - $1,342 186%
Ambetter / Centene $453 186%
Care Improvement Plus $453 186%
Caresource $453 186%
Cigna $453 - $1,375 186%
Coventry $453 - $1,258 186%
Eon Health Plan $453 186%
Humana $453 - $1,258 186%
Kaiser Permanente $453 186%
Molina $453 186%
Pruitthealth Premier $453 186%
Todays Options Pffs $453 186%
Todays Options Ppo $453 186%
UnitedHealthcare $453 - $2,632 186%
Vaccn United $453 186%
First Health $1,258 516%
Phcs $1,258 516%
Meritain $1,342 551%
Multiplan $1,425 - $1,459 585%
Nova $1,425 - $1,509 585%
Three Rivers Provider Network $1,509 619%
Amerigroup $1,677 688%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5401 Lake Oconee Parkway, Greensboro, GA 30642
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals