CT scan, abdomen and pelvis (no contrast)
Facility: Fredonia Regional Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $660
- Cash Discount Price: $733
- vs. Medicare Baseline: 2.71x 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 271% of the Medicare baseline (a markup of 171%). 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 | $363 - $480 | 149% |
| Veterans Programs - All Plans | $374 | 153% |
| Aetna | $374 - $660 | 153% |
| UnitedHealthcare | $374 - $660 | 153% |
| Reserve National-All Plans | $660 | 271% |
| Meritain-All Plans | $660 | 271% |
| Cigna | $660 | 271% |
Consumer Guidance & Cost Commentary
This CT scan of the abdomen and pelvis at Fredonia Regional Hospital in Kansas has a cash price of $733.00, which matches the facility's median negotiated rate. While the hospital is a Critical Access Hospital owned by the local government, the cash price is significantly higher than the Medicare benchmark of $243.77, indicating a markup of 2.7 times the federal rate. For patients with high-deductible plans, paying the full cash price of $733.00 upfront may be more cost-effective than relying on insurance, as many commercial payers negotiate rates that exceed this amount. For instance, Blue Cross Blue Shield and Veterans Programs have a maximum allowed amount of $480 and $374 respectively, meaning a patient could end up paying more out-of-pocket if their plan covers the difference between the cash price and the insurer's limit.
To minimize unexpected costs, patients should verify if the facility offers a "self-pay" or "prompt-pay" discount before scheduling, as these programs often provide a fee reduction for upfront payment. It is also 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 a balance bill arises from an out-of-network service, patients should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit to ensure they are not being charged for the difference between the provider's chargemaster rate and the allowed amount.