CT scan, abdomen and pelvis (no contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $652
- Cash Discount Price: $686
- vs. Medicare Baseline: 2.67x 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 267% of the Medicare baseline (a markup of 167%). 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 |
|---|---|---|
| Tricare | $549 | 225% |
| Humana | $624 | 256% |
| Aetna | $635 - $686 | 260% |
| Hpk-All Plans | $652 | 267% |
| UnitedHealthcare | $652 | 267% |
| Medicaid / KanCare | $686 | 281% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $686.00, which matches the facility's gross charge and the median amount paid by Medicaid/KanCare. While commercial insurance plans like Aetna, Humana, and UnitedHealthcare negotiate rates ranging from $624 to $686, these amounts are generally higher than the cash price due to administrative costs and contract structures. It is important to note that for patients with high-deductible plans, paying the cash price of $686.00 upfront may result in lower out-of-pocket costs compared to having insurance pay a negotiated rate that exceeds the cash price, provided the patient's deductible has not yet been met.
The facility's pricing is benchmarked against the Medicare rate of $243.77, which serves as a scientifically validated baseline for healthcare costs. The cash price of $686.00 represents a significant markup over this federal standard, reflecting the administrative load and contract dynamics typical of commercial billing. Patients should be aware that hospitals often offer prompt-pay discounts for self-pay customers who settle bills in full within 30 days, which can reduce the final amount owed. Additionally, because over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized statement to verify that all charges are accurate and that no services were unbundled or double-billed before making any payment.