CT scan, abdomen and pelvis (no contrast)
Facility: Holton Community Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $2,186
- Cash Discount Price: $1,976
- vs. Medicare Baseline: 8.97x 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 897% of the Medicare baseline (a markup of 797%). 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 | $453 | 186% |
| UnitedHealthcare | $1,396 - $2,634 | 573% |
| Aetna | $1,396 - $2,634 | 573% |
| Humana | $1,410 | 578% |
| Kansas Superior Select - All Plans | $1,424 | 584% |
| Preferred Health Fn Select - All Other Plans | $2,186 | 897% |
| Preferred Health Freedom | $2,186 | 897% |
| Preferred Health Professionals | $2,186 | 897% |
| Wppa Providers - All Plans | $2,502 | 1026% |
| Medicaid / KanCare | $2,634 | 1081% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Holton Community Hospital, the cash price is $1,976, which is lower than the facility's gross charge of $2,634. While the hospital is in-network for ten payers, the negotiated rates vary significantly; for instance, UnitedHealthcare and Aetna have negotiated rates ranging from $1,396 to $2,634, whereas Medicaid/KanCare pays the full gross amount of $2,634. It is important to note that for patients with high-deductible plans, paying the cash price of $1,976 upfront may be more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed the cash rate. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full within 30 days, effectively bypassing administrative fees and collection costs associated with insurance claims.
When evaluating the cost against state and county standards, the facility's cash rate of $1,976 is notably higher than the Medicare benchmark of $243.77, reflecting the typical commercial markup structure where negotiated rates often average 200% to 300% of Medicare amounts. However, the median negotiated rate across all payers is $2,186, which is slightly higher than the cash price, suggesting that self-pay or prompt-pay options may offer the best value for this procedure. To ensure you are not overcharged, it is recommended to request an itemized bill before scheduling, as summary bills often obscure individual line items and potential errors.