CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Kirby Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $189
Cash Discount Price: $3,000
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Kirby Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,000. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.78x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.

Cash / Self-Pay

$3,000

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $3,000 (1231%)

Insurance Median: $189 (78%)

Cash: $3,000 (1231% of Medicare)

Ins. Median: $189 (78% 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
Blue Cross Blue Shield	$64 - $4,900	26%
Aetna	$80 - $3,500	33%
Meridian	$80 - $1,550	33%
UnitedHealthcare	$80 - $3,445	33%
Wellcare	$80 - $1,550	33%
Molina	$82 - $1,596	34%
Zelis (Hfn)	$100 - $4,500	41%
Humana	$131 - $3,750	54%
Catepillar, Inc.	$160 - $4,250	66%
Healthlink	$495 - $4,500	203%
Multiplan/Phcs	$495 - $4,750	203%
Cigna	$4,000	1641%

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 $3,000.
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 Kirby Medical Center 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.