CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Good Samaritan Medical Center

Billing Code: 74176 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$334

about 1.4× the $244 Medicare rate · typically $265–$571

modeled estimate · not a bill or quote

What this hospital charges insurers

$332

About the fair price

about $2 under the fair price · 1.4× Medicare

Medicare pays $244 Fair price $334 This hospital $332 Cash price $338 Hospital's list price $751

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $230 Priciest $332

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, abdomen and pelvis (no contrast) is about $334 (about 1.4× the $244 Medicare rate). Good Samaritan Medical Center charges insurers about $332, or about $338 in cash — about the fair price. Located in Brockton, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$286	117%
Blue Cross Blue Shieldmajor	$286 - $574	117%
Aetnamajor	$286 - $361	117%
Cignamajor	$450 - $814	185%
Humanamajor	$286	117%
Harvard Pilgrim	$374	153%
Tufts Health Plan	$695 - $814	285%
UniCare	$563	231%
+ 13 smaller / regional plans	$286 - $434

Government programs also on file: Medicare, Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 338), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 74176.

Insurance Before you use insurance

Call your insurance company to confirm Good Samaritan Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 74176.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Good Samaritan Medical Center

Compare: CT scan, abdomen and pelvis (no contrast) at other MA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.