CT scan, abdomen and pelvis (no contrast)
Facility: Decatur Health
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $852
- Cash Discount Price: $1,005
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 | $589 | 242% |
| Wppa/Providrs Care- All Plans | $670 | 275% |
| UnitedHealthcare | $681 - $852 | 279% |
| Humana | $688 | 282% |
| Midlands Choice- All Plans | $1,005 | 412% |
| Aetna | $1,005 - $1,116 | 412% |
| Medicaid / KanCare | $1,128 | 463% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Decatur Health in Oberlin, Kansas, the cash price is $1,005, which is lower than the facility's negotiated rates for most major insurers like Aetna and UnitedHealthcare. While the facility is a Critical Access Hospital with a voluntary non-profit ownership, patients should be aware that insurance plans often pay more than the cash price due to administrative costs and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $1,005 upfront might result in lower out-of-pocket costs compared to your insurance's negotiated rate, which ranges from $589 for Blue Cross Blue Shield to $1,116 for Aetna.
To ensure you are not overcharged, it is recommended to request a full itemized bill before signing any consent waivers, as summary bills can obscure individual line items and potential errors. Additionally, since the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should verify that all ancillary services, such as lab work, are covered under your plan's network. If you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can further reduce the cost, and always compare the facility's rates to the state average to confirm fair pricing.