CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Veterans Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,129
Cash Discount Price: $1,137
vs. Medicare Baseline: 4.63x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Veterans Memorial Hospital is $1,129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,137. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.63x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.

Cash / Self-Pay

$1,137

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,129

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: $1,137 (466%)

Insurance Median: $1,129 (463%)

Cash: $1,137 (466% of Medicare)

Ins. Median: $1,129 (463% 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 463% of the Medicare baseline (a markup of 363%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$65 - $2,337	27%
Quartz Comm - All Other Plans	$65 - $2,337	27%
Aetna	$76 - $2,081	31%
Amerigroup Mcr Adv	$76 - $1,340	31%
Iowa Total Care Exchange	$76 - $1,340	31%
Molina Mcr Adv	$76 - $1,340	31%
Quartz Mcr Adv	$76 - $1,340	31%
Welmark Mcr Adv	$76 - $1,340	31%
Amerigroup Mcaid - All Other Plans	$244 - $872	100%
Wellmark Hmo - All Other Plans	$346	142%
Wellmark Ppo	$380	156%
Iowa Total Care Mcaid - All Other Plans	$872 - $1,589	358%
Molina Mcaid - All Other Plans	$872 - $1,589	358%
Medica Comm - All Other Plans	$918	377%
Iowa Total Care Mcr Adv	$1,340	550%
Medica Mcr Adv	$1,340	550%
UnitedHealthcare	$1,340 - $2,649	550%

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 $1,137.
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 Veterans 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.