CMS Price Transparency Data
CT scan, abdomen and pelvis (no contrast)
Facility: St Marys Good Samaritan Hospital
Billing Code: 74176 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$550
about 2.3× the $244 Medicare rate · typically $220–$1,201
modeled estimate · not a bill or quote
Medicare pays $244 Fair price $550 Cash price $1,090 Hospital's list price $1,677
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
6 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $453 - $2,632 | 186% |
| Blue Cross Blue Shieldmajor | $324 - $1,212 | 133% |
| Aetnamajor | $453 - $1,342 | 186% |
| Cignamajor | $453 - $1,375 | 186% |
| Humanamajor | $453 - $1,258 | 186% |
| Kaiser Permanentemajor | $453 | 186% |
| Ambetter (Centene) | $453 | 186% |
| Amerigroup | $1,677 | 688% |
| CareSource | $453 | 186% |
| Molina | $453 | 186% |
| WellCare | $189 - $453 | 78% |
| + 5 smaller / regional plans | $453 - $1,509 |
Government programs also on file: Medicaid, Military & VA.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Enter your details and press estimate to compare.
Other Procedures at St Marys Good Samaritan Hospital
Compare: CT scan, abdomen and pelvis (no contrast) at other GA hospitals
- Emanuel Medical Center · Swainsboro $70
- Atrium Health Navicent Peach · Byron $108
- Grady Memorial Hospital · Atlanta $112
- Hamilton Medical Center · Dalton $145
- Savannah Health Services LLC DBA Memorial Health University Medical Center · Savannah $146
- Shepherd Center, Inc. · Atlanta $156
- Atrium Health Navicent the Medical Center · Macon $167
- Navicent Health Baldwin · Milledgeville $167
Insurance negotiated median for the same procedure, sorted lowest first.