CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: William Newton Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $829
  • Cash Discount Price: $2,302
  • vs. Medicare Baseline: 3.40x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at William Newton Hospital is $829. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,302. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.40x the Medicare baseline. Located in 1300 East Fifth Avenue, Winfield, KS.
Cash / Self-Pay
$2,302

Average discount available for prompt cash payment at this facility.

Insurance Median
$829

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,302 (944%)
Insurance Median: $829 (340%)
Cash: $2,302 (944% of Medicare)
Ins. Median: $829 (340% of 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 340% of the Medicare baseline (a markup of 240%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $456 - $829 187%
Triwest- All Plans $804 330%
UnitedHealthcare $829 - $2,072 340%
Ambetter / Centene $829 - $2,302 340%
Providrs Care Nexus $1,409 578%
Providrs Care - All Other Plans $1,611 661%

Consumer Guidance & Cost Commentary

For a CT scan of the abdomen and pelvis (no contrast) at William Newton Hospital in Winfield, KS, the cash price is $2,302.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average, as indicated by a 3.4x markup relative to the Medicare benchmark of $243.77. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance plans like Blue Cross Blue Shield and Triwest-All Plans have negotiated rates ranging from $456 to $829, which are lower than the cash price. However, if a patient has a high-deductible plan that has not yet met their out-of-pocket maximum, paying the cash price upfront could result in lower total costs compared to the insurance negotiated rate, provided the patient can secure a prompt-pay discount.

To minimize out-of-pocket expenses, patients should proactively contact the hospital billing department before scheduling to request self-pay or prompt-pay discounts, which can reduce the $2,302.00 charge by 20% to 50%. It is crucial to sign a waiver of insurance submission to ensure the facility processes the account as a self-pay case rather than submitting a claim that would trigger the higher negotiated rate. Additionally, patients should request a full itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute. Given the facility's location in Winfield (ZIP 67156), comparing these specific charges against local county averages is essential

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 East Fifth Avenue, Winfield, KS 67156
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals