CT scan, abdomen and pelvis (no contrast)
Facility: Nmc Health
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,273
- Cash Discount Price: $1,425
- vs. Medicare Baseline: 5.22x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 522% of the Medicare baseline (a markup of 422%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bluestem Pace | $225 | 92% |
| Medicaid / KanCare | $361 | 148% |
| Leading Age | $361 | 148% |
| Blue Cross Blue Shield | $480 | 197% |
| Wppa | $1,120 | 459% |
| Occunet | $1,222 | 501% |
| Medincrease Health Plan | $1,323 | 543% |
| Samaritan Ministries International | $1,323 | 543% |
| Prime Health Services | $1,527 | 626% |
| Aetna | $1,678 | 688% |
| UnitedHealthcare | $1,832 | 752% |
| Cigna | $1,934 | 793% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Nmc Health in Newton, Kansas, the facility's cash price is $1,425. This cash rate is significantly lower than the negotiated rates charged to insurance plans, which range from $225 for Medicaid/KanCare up to $1,934 for Cigna. While the facility's negotiated average is $1,273, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that the facility's cash rate is also lower than the state average for this procedure, making it a competitive option for self-pay patients.
To ensure you receive the most accurate billing, always request an itemized bill before paying, as summary invoices can hide errors or unbundled charges. Additionally, ask specifically about "prompt-pay" discounts, which can reduce the final amount if settled in full within 30 days, bypassing the administrative costs associated with insurance claims. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full charge and your insurance's allowed amount for emergency care and non-emergency services at in-network facilities.