CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Elkhart General Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,053
Cash Discount Price: $2,224
vs. Medicare Baseline: 8.42x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Elkhart General Hospital is $2,053. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,224. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.42x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$2,224

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,053

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: $2,224 (912%)

Insurance Median: $2,053 (842%)

Cash: $2,224 (912% of Medicare)

Ins. Median: $2,053 (842% 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 842% of the Medicare baseline (a markup of 742%). 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
Mclaren (Mi	$136	56%
UnitedHealthcare	$136 - $2,300	56%
Aetna	$253 - $2,317	104%
Blue Cross Blue Shield	$253 - $842	104%
Humana	$253 - $2,395	104%
Pace	$253	104%
Devoted Healthcare	$266 - $684	109%
Caresource	$350 - $4,449	144%
Mdwise	$350 - $4,449	144%
Mhs	$350 - $4,449	144%
Plain Church	$380 - $2,738	156%
Cha	$2,053 - $2,669	842%
Immergrun	$2,053 - $2,738	842%
Php	$2,224 - $2,395	912%
Cigna	$2,464 - $2,601	1011%
Multiplan	$2,464	1011%
Signature	$2,498	1025%
Encore	$2,532	1039%
Heartland	$3,422	1404%

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 $2,224.
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 Elkhart General 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.