CT scan, abdomen and pelvis (no contrast)
Facility: Kiowa County Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $850
- Cash Discount Price: $812
- vs. Medicare Baseline: 3.49x 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 349% of the Medicare baseline (a markup of 249%). 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 - $850 | 188% |
| UnitedHealthcare | $765 - $955 | 314% |
| Health Partners Of Ks-All Plans | $840 | 345% |
| Aetna | $850 | 349% |
| Humana | $850 | 349% |
| Celtic Comml Exchange-All Other Plans | $850 | 349% |
| Medica Prime Mcare Cost-All Plans | $850 | 349% |
| Medicaid / KanCare | $955 | 392% |
| Providrs Care/Wppa-All Plans | $1,432 | 587% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Kiowa County Memorial Hospital in Greensburg, Kansas, the cash price is $812.00, which is lower than the facility's gross charge of $955.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative costs and claim processing fees. For instance, UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $765 to $955, which are higher than the cash price. In such cases, paying cash or utilizing a prompt-pay discount before scheduling can save patients money, provided they request a self-pay classification and sign a waiver to prevent automatic claims submission.
The facility's pricing is also contextualized by the Medicare benchmark, which stands at $243.77 for this procedure. Commercial negotiated rates for this service average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. Although specific county or state average data was not provided in the source material, patients should verify their plan's deductible status before relying on insurance, as high deductibles can result in paying the full negotiated rate. Additionally, if a patient receives care from out-of-network providers at this in-network facility, the No Surprises Act protects them from balance billing for emergency services, though they should still request an itemized bill to identify any unbundled codes or services not rendered.