CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Anderson Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,232
Cash Discount Price: $3,083
vs. Medicare Baseline: 5.05x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Anderson Hospital is $1,232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,083. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.05x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$3,083

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,232

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: $3,083 (1265%)

Insurance Median: $1,232 (505%)

Cash: $3,083 (1265% of Medicare)

Ins. Median: $1,232 (505% 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 505% of the Medicare baseline (a markup of 405%). 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
Health Care Service Corporation	$122 - $2,821	50%
Tricare	$172 - $4,590	71%
Humana	$174 - $4,785	71%
Medicare (plans)	$174 - $4,785	71%
UnitedHealthcare	$174 - $4,785	71%
Medicaid / KanCare	$176 - $382	72%
Aetna	$252 - $4,785	103%
Essence	$256 - $5,028	105%
Devoted Health Ppo	$257 - $4,881	105%
Clear Springs Health	$259 - $4,929	106%
Mercy Benefit Admin	$331	136%
Mercy Aco	$338	139%
Ambetter / Centene	$371 - $7,079	152%
Blue Choice	$371 - $7,079	152%
Hopetrust	$639 - $12,205	262%
Healthlink	$1,198 - $1,265	491%
Self Pay	$3,083 - $25,000	1265%
Work Comp	$3,281 - $26,600	1346%
Blue Cross Blue Shield	$3,307 - $3,425	1357%
Cigna	$4,244	1741%
Multiplan/Phcs	$4,625	1897%
Beech Street Corporation	$5,550	2277%

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 $3,083.
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 Anderson 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.