CT scan, abdomen and pelvis (no contrast)
Facility: Bob Wilson Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $3,714
- Cash Discount Price: $1,818
- vs. Medicare Baseline: 15.24x 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 1524% of the Medicare baseline (a markup of 1424%). 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 |
|---|---|---|
| Centura Employee Plan | $337 | 138% |
| Blue Cross Blue Shield | $641 | 263% |
| UnitedHealthcare | $1,455 - $3,791 | 597% |
| Medicare (plans) | $1,455 | 597% |
| Humana | $1,455 | 597% |
| Aetna | $1,455 - $3,637 | 597% |
| Kansas Health | $1,455 | 597% |
| Multiplan | $4,091 - $4,228 | 1678% |
| Health Partners Of Kansas | $4,273 | 1753% |
| Wppa | $4,319 | 1772% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Bob Wilson Memorial Hospital in Ulysses, KS, the cash median price is $1,818, while the median negotiated rate across insurance plans is $3,714. This significant difference highlights that paying out-of-pocket can be substantially cheaper than using insurance, especially for patients with high deductibles where the insurer's negotiated rate might exceed the cash price. Although the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
When comparing pricing against federal benchmarks, the Medicare allowed amount for this procedure is $243.77, which serves as a baseline for evaluating the facility's cost structure. The gross charge of $4,546 represents the full list price before any discounts, but the actual amounts paid by various payers range from $337 for Centura Employee Plans to $4,319 for WPPA, with UnitedHealthcare and Aetna showing a wide variance between $1,455 and $3,791. While the data does not provide specific state or county average comparisons for this code, the substantial gap between the Medicare rate and the commercial negotiated rates underscores the importance of verifying your specific plan's allowed amount and confirming whether the facility is truly in-network to avoid unexpected balance billing or out-of-network surcharges.