CT scan, abdomen and pelvis (no contrast)
Facility: Phillips County Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $580
- Cash Discount Price: $515
- vs. Medicare Baseline: 2.38x 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 238% of the Medicare baseline (a markup of 138%). 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 |
|---|---|---|
| UnitedHealthcare | $464 - $632 | 190% |
| Blue Cross Blue Shield | $470 - $512 | 193% |
| Health Partners-All Plans | $580 - $632 | 238% |
| Medicaid / KanCare | $580 - $632 | 238% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Phillips County Hospital in Phillipsburg, Kansas, the facility's negotiated rates range from $464 to $632 depending on your specific insurance plan. While the median negotiated amount is $580, the cash price is significantly lower at $515, and the cash median is $515. This suggests that paying out-of-pocket or using a prompt-pay discount could save you money compared to using insurance, especially if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. It is important to ask the hospital about self-pay or prompt-pay discounts before scheduling your visit, as these upfront payment incentives can reduce the total cost by bypassing the administrative overhead of claims processing.
When evaluating the cost of this service, it is helpful to compare the facility's pricing against the Medicare benchmark, which stands at $243.77. The facility's gross charge of $606 represents a markup relative to this federal baseline, illustrating how commercial rates are often structured above the true cost of care. Additionally, the median amount paid by insurers is $509, which is slightly lower than the cash median, indicating that for some patients, using insurance may result in a lower out-of-pocket expense than paying cash directly. Always verify your specific plan's allowed amount and check for any balance billing protections, such as those under the No Surprises Act, to ensure you are not liable for unexpected differences between the negotiated rate and what your insurance covers.