CT scan, abdomen and pelvis (no contrast)
Facility: Sheridan County Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $662
- Cash Discount Price: $981
- vs. Medicare Baseline: 2.72x 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 272% of the Medicare baseline (a markup of 172%). 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 |
|---|---|---|
| Celtic Insurance | $594 | 244% |
| Blue Cross Blue Shield | $662 | 272% |
| UnitedHealthcare | $932 | 382% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Sheridan County Hospital in Hoxie, Kansas, the cash price is $981.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, as indicated by a 2.7x multiplier compared to the Medicare benchmark of $243.77. While commercial insurance plans like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates ranging from $594 to $932, these figures often exceed the cash price for patients with high-deductible plans. In such cases, paying out-of-pocket may result in lower total costs, provided you verify the specific allowed amount for your plan and confirm that the facility offers a self-pay or prompt-pay discount to bypass standard insurance billing cycles.
It is important to understand that the negotiated rates shown for payers like UnitedHealthcare ($932) represent contractual ceilings rather than guaranteed out-of-pocket costs, as these amounts are subject to your specific deductible and coinsurance. If you receive a bill that exceeds the cash price, you should request an itemized billing audit to identify potential errors, such as unbundled codes or services not rendered, which occur in over 80% of hospital bills. Additionally, if you are concerned about balance billing from out-of-network ancillary services, the No Surprises Act may protect you from paying the difference between the facility's chargemaster and your insurance allowed amount for emergency or non-emergency care at in-network facilities. Always dispute any unexpected charges in writing and avoid signing consent waivers that could inadvertently waive your protections against surprise billing.