CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Madison County Health Care System

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $2,145
  • Cash Discount Price: $2,640
  • vs. Medicare Baseline: 8.80x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Madison County Health Care System is $2,145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,640. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.80x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$2,640

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,145

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: $2,640 (1083%)
Insurance Median: $2,145 (880%)
Cash: $2,640 (1083% of Medicare)
Ins. Median: $2,145 (880% 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 880% of the Medicare baseline (a markup of 780%). 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
Blue Cross Blue Shield $1,042 - $1,146 427%
Aetna $1,419 - $2,145 582%
Medical Associates Hp - All Plans $1,419 582%
Medigold-All Plans $1,419 582%
Tricare $1,419 582%
UnitedHealthcare $1,419 - $2,970 582%
American Hp Mcr Adv-All Plans $1,490 611%
Iowa Total Care Mcaid-All Plans $1,551 636%
Molina Mcaid/Chip -All Plans $1,605 658%
Amerigroup Mcaid-All Plans $1,644 674%
Madison County Sheriff-All Plans $1,650 677%
Oscar - All Plans $2,128 873%
Corvel Wc-All Plans $2,970 1218%
Choicecare-All Plans $3,135 1286%
First Choice-All Plans $3,135 1286%
First Health-All Plans $3,135 1286%
Integrated Hp-All Plans $3,135 1286%
Mutual Of Omaha-All Plans $3,135 1286%
Plaines Health-All Plans $3,135 1286%
Preferred Hlth Ntwork-All Plans $3,135 1286%
Principal Healthcare-All Plans $3,135 1286%
Usa Managed Care-All Plans $3,135 1286%
Medimore Employee Hp - All Plans $3,234 1327%
Midlands Choice - All Plans $3,234 1327%
Benefit Admin Of America-All Plans $3,300 1354%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals