CT scan, abdomen and pelvis (no contrast)
Facility: Scott County Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,200
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.92x 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 492% of the Medicare baseline (a markup of 392%). 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 | $131 - $1,380 | 54% |
| Blue Cross Blue Shield | $480 | 197% |
| Humana | $610 | 250% |
| Wppa | $872 - $1,200 | 358% |
| Aetna | $1,308 | 537% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Scott County Hospital in Scott City, KS, the Medicare benchmark rate is $243.77, which serves as the objective baseline for evaluating pricing fairness. While the facility's median negotiated rate is $1,200.00, this figure represents the maximum amount commercial insurers like UnitedHealthcare, Blue Cross Blue Shield, and Humana are contractually allowed to pay, which often exceeds the true cost of care. It is important to note that cash-pay options may be more economical for patients with high-deductible plans, as the facility's cash price is not listed but could potentially be lower than the insurance negotiated ceiling. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paying in full upfront, effectively bypassing the administrative overhead and claim processing costs embedded in insurance rates.
The facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and while the data does not provide specific county or state average comparisons for this specific CPT code, the significant markup between the Medicare rate and the negotiated rate highlights the importance of understanding the difference between list prices and allowed amounts. Under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though they should still review their itemized bills to ensure no unbundled codes or services not rendered have been charged. Before scheduling, it is advisable to verify your specific plan's deductible status and request a waiver of insurance submission if you intend to pay cash directly to secure the best possible price.