CT scan, abdomen and pelvis (no contrast)
Facility: Rawlins County Health Center
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,253
- Cash Discount Price: $1,224
- vs. Medicare Baseline: 5.14x 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 514% of the Medicare baseline (a markup of 414%). 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 | $458 | 188% |
| UnitedHealthcare | $1,253 | 514% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Rawlins County Health Center in Atwood, Kansas, the facility's cash price is $1,224. This cash rate is notably lower than the negotiated rates charged by in-network insurers, such as UnitedHealthcare, which has a median negotiated rate of $1,253. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance coverage would allow, as the negotiated rate exceeds the cash amount. It is important to note that while the facility is located in Atwood (ZIP 67730), specific county or state average pricing data was not provided in this report, so comparisons to broader regional averages cannot be made.
The Medicare benchmark for this procedure is $243.77, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $1,224 represents a significant increase over the Medicare rate, reflecting the costs of facility operations and administrative overhead that are not covered by federal reimbursement. Commercial insurance contracts often result in higher out-of-pocket costs for patients because the negotiated rates include administrative processing fees and do not reflect the true cost basis used by Medicare. To minimize potential costs, patients should inquire directly with the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by offering immediate payment incentives. Additionally, if a patient receives a bill from an out-of-network provider at this facility, they should be aware of the No Surprises Act protections that may prevent balance billing for emergency or non-emergency services.