CT scan, abdomen and pelvis (no contrast)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,405
- Cash Discount Price: $2,723
- vs. Medicare Baseline: 5.76x 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 576% of the Medicare baseline (a markup of 476%). 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 | $480 | 197% |
| Aetna | $1,252 - $2,042 | 514% |
| UnitedHealthcare | $1,557 | 639% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Community Memorial Healthcare in Marysville, Kansas, the cash price is $2,723, which matches the facility's median paid amount. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the cash rate is significantly higher than the state average, as indicated by a 5.8% variance compared to Medicare benchmarks. Patients with high-deductible plans should consider paying cash directly, as the negotiated rates for in-network payers like Aetna and UnitedHealthcare range from $1,252 to $2,042, but these amounts often exceed the cash price once deductibles and copays are factored in. It is crucial to verify the specific status of your insurance plan and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the total cost by bypassing administrative fees and claims processing delays.
The data reveals that while the facility's gross charge is $2,723, the median amount actually paid by insurers is $2,178, with a negotiated average of $1,405. However, because the cash price is lower than the median paid amount, paying out-of-pocket may result in a lower out-of-pocket expense for some patients. To ensure you are not facing unexpected costs, it is important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a balance bill for out-of-network ancillary services, you may be protected under the No Surprises Act