CT scan, abdomen and pelvis (no contrast)
Facility: St Luke Hospital & Living Center
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,314
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.39x 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 539% of the Medicare baseline (a markup of 439%). 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 |
|---|---|---|
| Humana | $1,314 | 539% |
| Bluestem Pace | $1,314 | 539% |
| UnitedHealthcare | $1,314 | 539% |
| Va Ccn | $1,314 | 539% |
| Blue Cross Blue Shield | $1,314 | 539% |
| Kansas Department Of Health And Environment | $1,314 | 539% |
| Ambetter / Centene | $1,327 | 544% |
Consumer Guidance & Cost Commentary
For the CT scan of the abdomen and pelvis (no contrast) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $1,314, which matches the lowest and highest amounts reported across seven payers, including Humana, Blue Cross Blue Shield, and UnitedHealthcare. This negotiated rate is significantly higher than the Medicare benchmark of $243.77, reflecting the standard administrative markup inherent in commercial insurance contracts. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that cash-pay options are not listed in this report; however, it is always advisable to ask the billing department directly about "self-pay" or "prompt-pay" discounts, which can sometimes result in a lower total than the insurance negotiated rate, particularly for those with high-deductible plans.
The data indicates that the facility's pricing structure is consistent across all major insurers, with no variation between the low and high ends of the reported range for any single payer. Since the report does not provide specific county or state average data for comparison, patients should rely on the Medicare rate as the objective baseline to evaluate the facility's markup. If you receive a bill that exceeds the allowed amount from your insurance, it may be due to balance billing from out-of-network ancillary services or errors in the itemized statement. In such cases, you should request a full itemized audit to identify unbundled codes or services not rendered, and if applicable, dispute any surprise balance bills under the No Surprises Act before making a payment.