CT scan, abdomen and pelvis (no contrast)
Facility: Graham County Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $492
- Cash Discount Price: $635
- vs. Medicare Baseline: 2.02x 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 202% of the Medicare baseline (a markup of 102%). 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 |
|---|---|---|
| UnitedHealthcare | $109 - $603 | 45% |
| Medicaid / KanCare | $109 | 45% |
| Blue Cross Blue Shield | $453 | 186% |
| Medicare (plans) | $476 | 195% |
| Celtic Commercial-All Other Plans | $524 | 215% |
| Wppa (Providers Care)-All Plans | $603 | 247% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Graham County Hospital in Hill City, Kansas, the cash price is $635.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to insurance payers, with the lowest commercial rate being $453.00 and the highest reaching $603.00. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that cash payments can sometimes result in lower out-of-pocket costs compared to insurance claims, particularly if the patient has a high deductible or if the insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final bill.
When evaluating the cost against federal standards, the Medicare allowed amount for this procedure is $243.77, and the facility's cash rate represents a 200% markup relative to this benchmark. This aligns with the typical range where commercial rates average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150% of the Medicare rate. The data indicates six different payers with varying rates, ranging from Medicaid/KanCare at $109.00 to Wppa (Providers Care) at $603.00. To ensure you are receiving the most accurate pricing, always request an itemized bill before paying and verify that no balance billing occurs for out-of-network services, as federal protections like the No Surprises Act may apply depending on the specific services rendered.