CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Jacksonville Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $3,855
Cash Discount Price: $6,499
vs. Medicare Baseline: 15.81x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Jacksonville Memorial Hospital is $3,855. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,499. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.81x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$6,499

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,855

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: $6,499 (2666%)

Insurance Median: $3,855 (1581%)

Cash: $6,499 (2666% of Medicare)

Ins. Median: $3,855 (1581% 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 1581% of the Medicare baseline (a markup of 1481%). 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	$162 - $6,573	66%
Tricare	$171 - $1,198	70%
Coventry	$172 - $1,035	71%
Health Alliance	$172 - $4,470	71%
Humana	$172 - $5,607	71%
Medicare (plans)	$172 - $1,035	71%
UnitedHealthcare	$180 - $4,733	74%
Corvel/Corcare	$577 - $3,427	237%
Medicaid / KanCare	$595	244%
Molina Healthcare	$595	244%
Illinois Workers Compensation	$620 - $3,497	254%
Healthlink	$1,050 - $5,587	431%
Health Alliance Mh Employee Plan	$2,956 - $3,024	1213%
Commercial Workers Compensation	$3,247 - $3,322	1332%
Current Health Network	$3,534 - $4,930	1450%
6 Degrees Health	$3,855 - $3,944	1581%
Hope Trust	$3,855 - $3,944	1581%
Hst	$3,855 - $3,944	1581%
Cigna	$4,453 - $4,555	1827%
Aetna	$4,491 - $5,258	1842%
Phcs/Multiplan	$5,782 - $5,916	2372%
Hfn	$6,104 - $6,244	2504%
Liability	$6,425 - $6,573	2636%

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 $6,499.
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 Jacksonville 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.