CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Nemaha Valley Community Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $1,202
  • Cash Discount Price: $2,100
  • vs. Medicare Baseline: 4.93x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Nemaha Valley Community Hospital is $1,202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,100. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.93x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$2,100

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,202

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: $2,100 (861%)
Insurance Median: $1,202 (493%)
Cash: $2,100 (861% of Medicare)
Ins. Median: $1,202 (493% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 493% of the Medicare baseline (a markup of 393%). 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.

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
Blue Cross Blue Shield $480 197%
Humana $1,017 - $1,037 417%
Va Ccn - All Plans $1,017 - $1,037 417%
Aetna $1,027 - $2,003 421%
Celtic Comm Exch - All Plans $1,119 - $1,140 459%
Partners Direct Health - All Plans $1,202 - $1,225 493%
Multiplan - All Plans $2,080 - $2,120 853%
Health Partners - All Plans $2,195 - $2,238 900%
Midlands Choice - All Plans $2,195 - $2,238 900%

Consumer Guidance & Cost Commentary

For patients at Nemaha Valley Community Hospital in Seneca, KS, the cost of a CT scan of the abdomen and pelvis varies significantly depending on payment method. While the facility's cash median price is $2,100, commercial insurance plans typically pay negotiated rates ranging from $480 to $2,238, with Humana and VA plans averaging around $1,017 to $1,037. It is important to note that cash payments can sometimes be more economical for individuals with high-deductible plans if their insurance negotiated rate exceeds the cash price. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by paying upfront and bypassing administrative processing costs.

When evaluating the value of this service, it is crucial to compare rates against objective benchmarks rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $243.77, and the facility's cash rate is approximately 4.9 times higher than the Medicare benchmark, which is a common markup structure in the healthcare industry. Since over 80% of hospital bills contain errors, patients should request a detailed, itemized bill to ensure no services were double-billed or unbundled. If a balance bill arises from an out-of-network provider, patients should not pay immediately but instead dispute the charge with their insurer to protect against unexpected costs.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals