CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Wilcox Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $384
Cash Discount Price: $1,637
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Wilcox Memorial Hospital is $384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,637. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.58x the Medicare baseline. Located in 3-3420 Kuhio Highway, Lihue, HI.

Cash / Self-Pay

$1,637

Average discount available for prompt cash payment at this facility.

Insurance Median

$384

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: $1,637 (672%)

Insurance Median: $384 (158%)

Cash: $1,637 (672% of Medicare)

Ins. Median: $384 (158% 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.

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
Hmsa	$95 - $760	39%
UnitedHealthcare	$95	39%
Alohacare	$126 - $307	52%
Ohana	$130 - $795	53%
Mdx	$157 - $307	64%
Hwmg/Hmaa	$277	114%
Devoted	$321	132%
Pac Admin	$424	174%
Verdegard	$462	190%
Hcha	$1,450 - $2,264	595%
Kaiser	$1,450 - $2,264	595%
Multiplan	$1,450 - $2,406	595%

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 $1,637.
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 Wilcox Memorial 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.