CT scan, abdomen and pelvis (no contrast)
Facility: Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $1,351
- Cash Discount Price: $2,703
- vs. Medicare Baseline: 5.54x 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 554% of the Medicare baseline (a markup of 454%). 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 |
|---|---|---|
| Tricare | $425 - $1,351 | 174% |
| Medicare (plans) | $430 - $1,365 | 176% |
| Blue Cross Blue Shield | $484 | 199% |
| Coventry - All Other Plans | $766 - $2,432 | 314% |
| Health Partners Of Kansas - All Plans | $808 - $2,567 | 331% |
| Humana | $1,351 | 554% |
| Ambetter / Centene | $1,486 | 610% |
| Preferred Healthcare-All Plans | $2,567 | 1053% |
| Wppa/Providers Care-All Plans | $3,784 | 1552% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Memorial Hospital in Abilene, KS, the cash price is $2,703.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for this procedure, which is $940.00. While commercial insurance plans like Coventry and Health Partners of Kansas have negotiated rates ranging from $766 to $2,567, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially beneficial to pay the cash rate directly, as the insurance negotiated rates can sometimes be higher than the upfront cost. To maximize savings, it is recommended to contact the hospital directly to inquire about self-pay discounts or prompt-pay incentives, which can reduce the final bill by 20% to 50% if paid in full within a short window.
The facility's pricing is also evaluated against the Medicare benchmark, where the allowed amount is $243.77. The cash price of $2,703.00 represents a substantial markup compared to this federal baseline, highlighting the difference between government-set costs and commercial pricing. Although the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates for various payers vary widely, with Humana and Ambetter/Centene having fixed rates of $1,351 and $1,486, respectively. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still crucial to request an itemized bill to verify all charges and avoid unexpected fees. Always confirm the specific discount