CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $4,949
Cash Discount Price: $4,658
vs. Medicare Baseline: 20.30x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Memorial Hospital is $4,949. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,658. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 20.30x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$4,658

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,949

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: $4,658 (1911%)

Insurance Median: $4,949 (2030%)

Cash: $4,658 (1911% of Medicare)

Ins. Median: $4,949 (2030% 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 2030% of the Medicare baseline (a markup of 1930%). 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
Aetna	$558 - $4,157	229%
Consociate	$558 - $4,949	229%
Cigna	$1,000 - $3,326	410%
Humana	$1,094 - $5,822	449%
Blue Cross Blue Shield	$1,358 - $4,157	557%
First Health Network	$1,374 - $5,182	564%
Health Alliance	$1,630 - $5,822	669%
Meridian	$1,630 - $5,822	669%
Molina	$1,630 - $5,822	669%
UnitedHealthcare	$1,630 - $5,822	669%
Healthlink	$3,300 - $4,949	1354%
Private Healthcare Systems	$4,949	2030%
Integrated Health Plan	$5,123	2102%
Health Dynamics	$5,240	2150%
Health Payors Org	$5,240	2150%
Iowa Health Solutions	$5,240	2150%
Multiplan	$5,240	2150%
Preferred Plan Inc	$5,240	2150%
Three Rivers Provider Network	$5,240	2150%
Health First Network	$5,298	2173%
Pponext	$5,298	2173%
Corvel	$5,531	2269%

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 $4,658.
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 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.