CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Ascension St Vincent Randolph

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $147
Cash Discount Price: $2,568
vs. Medicare Baseline: 0.60x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Ascension St Vincent Randolph is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,568. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.60x the Medicare baseline. Located in 473 E Greenville Ave, Winchester, IN.

Cash / Self-Pay

$2,568

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $2,568 (1053%)

Insurance Median: $147 (60%)

Cash: $2,568 (1053% of Medicare)

Ins. Median: $147 (60% 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.

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	$62 - $2,974	25%
Medicaid / KanCare	$62 - $149	25%
Mhs Care Connect	$62 - $149	25%
UnitedHealthcare	$91 - $296	37%
Aetna	$147 - $650	60%
Ambetter / Centene	$147	60%
Ascension Complete Mcr	$147	60%
Caresource Marketplace	$147	60%
Corizon	$147	60%
Humana	$147	60%
Immergrun	$147	60%
Medicare (plans)	$147	60%
Personalized Care	$147	60%
Secure Horizons-Pacificare	$147	60%
Smarthealth Ppo	$150	62%
Smarthealth Ppo/Hdhp 20161001	$150	62%
Encore Exclusive	$336	138%
Patoka Valley Tier 1	$336	138%
Patoka Valley Tier 2	$336	138%

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 $2,568.
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 Ascension St Vincent Randolph 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.