CT scan, abdomen and pelvis (no contrast)
Facility: Hiawatha Community Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,782
- Cash Discount Price: $2,288
- vs. Medicare Baseline: 7.31x 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 731% of the Medicare baseline (a markup of 631%). 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 | $456 - $480 | 187% |
| Aetna | $847 - $1,849 | 347% |
| UnitedHealthcare | $847 - $1,965 | 347% |
| Humana | $855 | 351% |
| Ambetter / Centene | $1,016 | 417% |
| Centrus Health Direct - All Plans | $1,716 | 704% |
| Oscar - All Plans | $1,716 | 704% |
| Preferred Hlth - All Plans | $2,059 | 845% |
| Wppa Providrs Care - All Plans | $2,174 | 892% |
| Cigna | $2,174 | 892% |
| Multiplan - All Plans | $2,219 | 910% |
| Midlands Choice - All Plans | $2,219 | 910% |
| Healthy Blue Mcaid - All Plans | $2,288 | 939% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Hiawatha Community Hospital, the cash price is $2,288, which matches the facility's gross charge and the median cash rate. While the hospital is a Critical Access Hospital in Kansas, the data does not provide specific county or state average figures for comparison. However, the facility's negotiated rate of $1,782 is lower than the cash price, suggesting that using insurance may result in a lower out-of-pocket cost for most patients, provided their plan covers this service. It is important to note that cash payments can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though in this specific case, the negotiated amount is lower. Patients should verify their specific plan details and ask the hospital directly about any "self-pay" or "prompt-pay" discounts that might further reduce the final bill.
The Medicare benchmark for this procedure is $243.77, which serves as a baseline for evaluating the facility's pricing markup. The commercial negotiated rate of $1,782 is significantly higher than the Medicare amount, reflecting the administrative costs and contract dynamics typical of commercial insurance. If you are self-paying, you should request an itemized billing audit to ensure there are no errors, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Additionally, if you have insurance, be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, but you should confirm your network status before scheduling to avoid unexpected charges. Always check with the hospital's billing department regarding prompt-pay discounts and ensure you do not sign away your rights to