CT scan, abdomen and pelvis (no contrast)
Facility: Ellsworth County Medical Center
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,593
- Cash Discount Price: $1,770
- vs. Medicare Baseline: 6.53x 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 653% of the Medicare baseline (a markup of 553%). 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 | $430 - $453 | 176% |
| Healthy Blue Mcr Adv | $832 | 341% |
| Triwest -All Plans | $832 | 341% |
| Humana | $832 - $1,682 | 341% |
| Va Ccn-All Plans | $832 | 341% |
| UnitedHealthcare | $1,150 - $1,770 | 472% |
| Aetna | $1,593 | 653% |
| First Health - All Plans | $1,593 | 653% |
| Cigna | $1,682 | 690% |
| Medicaid / KanCare | $1,770 | 726% |
| Healthy Blue Mcaid- All Other Plans | $1,770 | 726% |
| Coventry Mcaid-All Plans | $1,770 | 726% |
| Providers Care-Wppa-All Plans | $2,655 | 1089% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Ellsworth County Medical Center, the cash price is $1,770, which matches the facility's gross charge and the Medicaid rate. While the median negotiated rate across 13 payers is $1,593, patients with high-deductible plans may find paying cash upfront more cost-effective if their insurance allows the full negotiated amount or if the patient's out-of-pocket maximum is not yet reached. It is important to note that the cash price here is identical to the gross charge, meaning no self-pay or prompt-pay discounts are listed in this specific price transparency report; however, patients should always ask the billing department directly about potential "self-pay" or "prompt-pay" discounts before scheduling, as these reductions can range from 20% to 50% for upfront payments.
When comparing this facility's pricing to broader benchmarks, the Medicare amount for this service is $243.77, which serves as the objective baseline for evaluating commercial rates. The facility's cash price of $1,770 represents a significant markup relative to the Medicare rate, consistent with how commercial negotiated rates often exceed fair pricing benchmarks. Additionally, the median paid amount across payers is $1,372, which is lower than the cash price, illustrating that for those with active insurance coverage, the actual cost to the patient is likely reduced by the insurance company's payment. Given that this is a Critical Access Hospital in Ellsworth, KS, patients should verify their specific plan details and request an itemized bill to ensure no errors or unbundled charges are included before finalizing payment.