CT scan, abdomen and pelvis (no contrast)
Facility: Ashland Health Center
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $667
- Cash Discount Price: $534
- vs. Medicare Baseline: 2.74x 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 274% of the Medicare baseline (a markup of 174%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $223 | 91% |
| Compalliance-All Plans | $534 | 219% |
| Health Partners Of Kansas-All Plans | $567 | 233% |
| Multiplan-All Plans | $654 | 268% |
| UnitedHealthcare | $667 | 274% |
| Aetna | $667 | 274% |
| Medicaid / KanCare | $667 | 274% |
| Medicare (plans) | $667 | 274% |
| Healthy Blue Mcr Adv - All Other Plans | $667 | 274% |
| Health Choice-All Plans | $667 | 274% |
| Medica Mcare - All Plans | $667 | 274% |
| Providers Care (Wppa)-All Plans | $1,000 | 410% |
Consumer Guidance & Cost Commentary
For the CT scan of the abdomen and pelvis (no contrast) at Ashland Health Center in Ashland, KS, the facility's cash median rate is $534.00, while the negotiated rate paid by most commercial payers is $667.00. This price transparency report highlights that patients with high-deductible plans might find the cash price more advantageous, as the negotiated rate exceeds the cash amount. To potentially lower costs, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts before scheduling, which can offer significant fee reductions for upfront payment. It is important to note that while the facility is a Critical Access Hospital, the cash rate of $534.00 remains the primary benchmark for self-pay patients, distinct from the higher amounts billed through insurance networks.
When evaluating the cost relative to federal standards, the Medicare amount for this procedure is $243.77. Under Medicare benchmarking principles, commercial negotiated rates often average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this baseline. In this specific case, the negotiated rate of $667.00 represents a substantial markup compared to the Medicare amount, illustrating the difference between the government's cost-based reimbursement and commercial contract pricing. Patients should be aware that comparing rates to the hospital's gross charge list can be misleading; instead, comparing the allowed amounts to the Medicare rate provides a scientifically validated view of the facility's pricing structure.