CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Jeff Davis Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $4,626
  • Cash Discount Price: $2,159
  • vs. Medicare Baseline: 18.98x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Jeff Davis Hospital is $4,626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,159. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 18.98x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.
Cash / Self-Pay
$2,159

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,626

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: $2,159 (886%)
Insurance Median: $4,626 (1898%)
Cash: $2,159 (886% of Medicare)
Ins. Median: $4,626 (1898% 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 1898% of the Medicare baseline (a markup of 1798%). 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
Pen_Network $267 110%
Medicaid / KanCare $1,203 - $3,306 493%
Humana $1,227 - $5,243 503%
Peach_State $1,227 503%
Wellcare $1,227 503%
Medicare (plans) $1,912 - $1,931 784%
Blue Cross Blue Shield $1,950 - $4,626 800%
Care_Improvement_Plus $1,950 800%
Coventry_Hmo $4,318 1771%
Coventry_Pos $4,318 1771%
Uhc_Hmo $4,626 1898%
Uhc_Indemnity $4,626 1898%
Uhc_Ppo $4,626 1898%
Coventry_Ppo $4,750 1949%
Beech_Street $4,935 2024%
Care_Source $4,935 2024%
Cigna $4,935 2024%
One_Health_Ppo $4,935 2024%
Choicecare $5,243 2151%
Community_Care_Network $5,243 2151%
Georgia_Hospital_Network $5,243 2151%
Industry_Buying_Group $5,243 2151%
Novanet $5,243 2151%
Principal_Health_Care_Of_Georgia $5,243 2151%
Three_Rivers_Provider_Network $5,243 2151%
Usa_Managed_Care $5,243 2151%
Memorial_Health_Partners $5,552 2278%
Tricare $5,737 2353%
Multiplan $5,860 2404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 163 South Tallahassee Street, Hazlehurst, GA 31539
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals