CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Lmh

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $240
  • Cash Discount Price: $1,377
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Lmh is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,377. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$1,377

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $1,377 (565%)
Insurance Median: $240 (98%)
Cash: $1,377 (565% of Medicare)
Ins. Median: $240 (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 $90 - $240 37%
Cigna $90 - $3,679 37%
UnitedHealthcare $90 - $3,656 37%
Medicare (plans) $90 - $240 37%
Haskell Indian Health Services $105 - $240 43%
Blue Cross Blue Shield $105 - $3,563 43%
Ambetter / Centene $107 - $372 44%
Allwell $107 - $245 44%
Aetna $1,835 - $4,571 753%
Non Contracted $4,405 1807%
First Health $5,121 2101%

Consumer Guidance & Cost Commentary

For this CT scan of the abdomen and pelvis at Lmh in Lawrence, KS, the cash median price is $1,377, which is significantly lower than the facility's gross charge of $5,507. While the facility is government-owned and holds a 4-star rating, patients with high-deductible plans may find the cash price more affordable than their insurance negotiated rates, which range from $90 to $5,121 depending on the carrier. It is important to note that commercial negotiated rates often include administrative overhead and can exceed the cash price; therefore, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not paying the full insurance allowed amount.

The Medicare benchmark for this service is $243.77, which serves as a reliable baseline for evaluating the facility's pricing markup rather than the inflated chargemaster list. Although the data does not provide specific county or state average comparisons for this code, the wide variance in negotiated rates across payers—such as the $4405 charged by non-contracted providers versus the $90 low-end rates for some plans—highlights the importance of verifying your specific plan's allowed amount. To avoid unexpected balance billing, patients should request an itemized bill to review every CPT code and ensure no services were unbundled or charged for items not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals