CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Mercyone Newton Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $1,570
  • Cash Discount Price: $3,052
  • vs. Medicare Baseline: 6.44x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercyone Newton Medical Center is $1,570. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,052. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.44x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$3,052

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,570

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: $3,052 (1252%)
Insurance Median: $1,570 (644%)
Cash: $3,052 (1252% of Medicare)
Ins. Median: $1,570 (644% 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 644% of the Medicare baseline (a markup of 544%). 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
Aetna $226 - $4,400 93%
Medicare (plans) $226 - $235 93%
Blue Cross Blue Shield $228 - $244 94%
UnitedHealthcare $230 - $2,677 94%
Blue Benefit Administrators Of Massachusetts $244 100%
Blue Care Network $244 100%
Blue Distinction Transplant $244 100%
Blue Shield - Ca $244 100%
Blue Shield - Id (Regence) $244 100%
Blue Shield - Ny Highmark Northeastern $244 100%
Blue Shield - Ny Highmark Western $244 100%
Blue Shield - Pa (Highmark) $244 100%
Blue Shield - Wa (Regence) $244 100%
Iowa Total Care $275 113%
Medicaid / KanCare $278 - $279 114%
Amish Hospital Aid $307 126%
Oscar $327 134%
Centivo $333 137%
Ambetter / Centene $387 159%
Claimdoc $463 190%
Nova $463 190%
Geha $2,677 1098%
Newton Correctional Facility $3,052 1252%
Health Choices $3,545 1454%
Medical Associates $3,545 1454%
Health Partners $4,142 1699%
Auxiant $4,320 1772%
Cigna $4,320 1772%
Health Alliance $4,320 1772%
Medica $4,320 1772%
Midlands $4,320 1772%
Midlands Choice $4,320 1772%
1199 National Benefit Fund $4,400 1805%
Allied Benefit Systems $4,400 1805%
Asr Health Benefits $4,400 1805%
Christian Brother Services $4,400 1805%
Coventry $4,400 1805%
First Health $4,400 1805%
Lucent Health $4,400 1805%
Luminare Health $4,400 1805%
Medical Mutual $4,400 1805%
Meritain $4,400 1805%
Trustmark Small Business Benefits $4,400 1805%
Webtpa $4,400 1805%
Crime Victim Assistance $4,696 1926%
Iowa Dept Of Public Health $4,696 1926%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals