CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $238
  • Cash Discount Price: $2,868
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Hospital Pittsburg, Inc is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,868. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$2,868

Average discount available for prompt cash payment at this facility.

Insurance Median
$238

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: $2,868 (1177%)
Insurance Median: $238 (98%)
Cash: $2,868 (1177% of Medicare)
Ins. Median: $238 (98% 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.

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
Humana $89 - $231 37%
Aetna $89 - $3,751 37%
Medicaid / KanCare $89 - $235 37%
Blue Cross Blue Shield $131 - $578 54%
UnitedHealthcare $206 - $2,974 85%
Elara Caring Aspire Hospice [20433] $231 95%
Halo Hcr Inc Hospice Contracted [320432] $231 95%
Kindful Hospice Contracted [320434] $231 95%
Cross Timbers Hospice [20098] $231 95%
Halo Hcr Inc Hospice [20432] $231 95%
Medicare (plans) $231 - $240 95%
Kindful Hospice [20434] $231 95%
Pace Of The Ozarks Contracted [320518] $231 95%
Tricare $231 95%
American Health Advantage Of Ks Mcr Contracted [320508] $231 95%
Mercy Hospice Okc [20252] $231 95%
Dept Of Veteran Affairs Contracted [320106] $231 95%
Ambetter / Centene $235 96%
Home State Health Plan Contracted [320187] $235 96%
Providrs Care Network Contracted [320484] $447 183%
Health Choice Contracted [320166] $544 223%
Medica Contracted [320239] $734 301%
Cigna $912 - $935 374%
United Medical Resources Contracted [320454] $2,974 1220%
Healthlink Contracted [320179] $3,530 1448%
Workers Comp [20426] $3,530 1448%
Yuzu Health Contracted [320521] $3,530 1448%
Ebms Contracted [320493] $3,530 1448%
Reflect Health Contracted [320492] $3,530 1448%
Edison Health Solutions Contracted [320502] $3,530 1448%
Mercy Benefit Admin Contracted [320251] $3,530 1448%
Imagine 360 Contracted [320494] $3,530 1448%
Aither Health Contracted [320449] $3,530 1448%
Auxiant Contracted [320462] $3,530 1448%
American Healthcare Alliance Contracted [320020] $3,530 1448%
First Health Contracted [320128] $3,751 1539%

Consumer Guidance & Cost Commentary

For this CT scan of the abdomen and pelvis at Mercy Hospital Pittsburg, Inc, the facility's cash price is $2,868, which is lower than the gross charge of $4,413. While many commercial payers negotiate rates significantly higher than the cash price—ranging from $231 for some plans up to $3,751 for others—patients with high-deductible plans may find paying cash directly more cost-effective. The facility offers a prompt-pay discount for upfront payment, which can reduce the final bill, so it is advisable to ask about self-pay rates and request a waiver of insurance submission before scheduling to avoid automatic claims processing.

The negotiated rates for this procedure vary widely depending on the insurance carrier, with some plans paying as little as $89 and others up to $3,751. Notably, the median negotiated amount across all payers is $238, which is substantially lower than the cash price, suggesting that for most insured patients, using their insurance will result in a lower out-of-pocket cost than paying cash. However, patients should be aware that balance billing could occur if they receive care from out-of-network providers, though the No Surprises Act protects against such unexpected bills for emergency services and non-emergency services at in-network facilities. Always verify your specific plan's allowed amount and deductible status before proceeding to ensure you are not paying more than necessary.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals