CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Valley West Community Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $4,396
Cash Discount Price: $4,802
vs. Medicare Baseline: 18.03x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Valley West Community Hospital is $4,396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,802. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 18.03x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.

Cash / Self-Pay

$4,802

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,396

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: $4,802 (1970%)

Insurance Median: $4,396 (1803%)

Cash: $4,802 (1970% of Medicare)

Ins. Median: $4,396 (1803% 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 1803% of the Medicare baseline (a markup of 1703%). 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
Blue Cross Blue Shield	$1,303 - $5,605	535%
Global Excel [1712]	$1,303	535%
Humana	$1,303	535%
Aetna	$1,742 - $4,754	715%
Health'S Finest Network [126]	$3,087 - $5,831	1266%
The Alliance [1703]	$3,728	1529%
Choicecare [177]	$4,624	1897%
Healthlink [125]	$5,145	2111%
Multiplan/Phcs [142]	$5,488 - $6,860	2251%
First Health Plan [6034]	$6,860	2814%
UnitedHealthcare	$6,860	2814%

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 $4,802.
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 Valley West Community 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.