CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Pulaski Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $170
Cash Discount Price: $1,809
vs. Medicare Baseline: 0.70x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Pulaski Memorial Hospital is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,809. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.70x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$1,809

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $1,809 (742%)

Insurance Median: $170 (70%)

Cash: $1,809 (742% of Medicare)

Ins. Median: $170 (70% 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
UnitedHealthcare	$73 - $3,893	30%
Ambetter / Centene	$77 - $1,528	32%
Blue Cross Blue Shield	$77 - $3,170	32%
Caresource Mcaid Hip	$77 - $1,528	32%
Caresource Mcare Hmo	$77 - $1,528	32%
Cenpatico Mcaid Hip	$77 - $1,528	32%
Humana	$77 - $3,962	32%
Mdwise Mcaid Hcc	$77 - $90	32%
Mdwise Mcaid Hhw	$77 - $90	32%
Mdwise Mcaid Hip - All Other Plans	$77 - $1,528	32%
Mhs Mcaid Hip	$77 - $1,528	32%
Mhs Mcare Allwell	$77 - $1,543	32%
Multiplan - All Plans	$77 - $4,435	32%
Caresource Mcaid Hhw	$90 - $170	37%
Cenpatico Mcaid Hhw - All Other Plans	$90 - $170	37%
Mhs Mcaid Hhw/Hcc	$90 - $170	37%
Caresource Exch Hmo Hix - All Other Plans	$96 - $1,909	39%
Cigna	$100 - $4,681	41%
Sagamore - All Other Plans	$100 - $3,725	41%
Sagamore Rose Acre	$100 - $3,671	41%
Encore Ppo - All Other Plans	$117 - $4,189	48%
Community Health Alliance - All Plans	$153 - $4,386	63%
Encore Workers Comp	$216 - $4,435	89%
Aetna	$1,774	728%

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 $1,809.
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 Pulaski 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.