CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Hamilton Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,105
Cash Discount Price: $2,441
vs. Medicare Baseline: 8.64x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Hamilton Memorial Hospital is $2,105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,441. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.64x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.

Cash / Self-Pay

$2,441

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,105

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: $2,441 (1001%)

Insurance Median: $2,105 (864%)

Cash: $2,441 (1001% of Medicare)

Ins. Median: $2,105 (864% 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 864% of the Medicare baseline (a markup of 764%). 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	$174 - $2,585	71%
Blue Cross Blue Shield	$174 - $2,613	71%
Health Alliance	$174 - $2,297	71%
Medicare (plans)	$174 - $1,149	71%
UnitedHealthcare	$174 - $2,056	71%
Wellcare	$174 - $1,149	71%
Healthlink	$787 - $910	323%
Medicaid / KanCare	$1,068 - $1,149	438%
Alliance Coal	$1,149	471%
Humana	$1,149	471%
Healthscope	$2,010	825%
Wellfirst (Ssmhic)	$2,010	825%
Hope Trust	$2,154	884%
Cigna	$2,254	925%
Hfn, Inc	$2,297 - $2,585	942%
Multiplan	$2,441	1001%
Siho	$2,585	1060%
Three Rivers Provider	$2,585	1060%
Healthsmart	$2,728	1119%
Stratose	$2,728	1119%

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 $2,441.
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 Hamilton 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.