CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Boston Children's Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,753
Cash Discount Price: $2,468
vs. Medicare Baseline: 7.19x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Boston Children's Hospital is $1,753. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,468. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.19x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$2,468

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,753

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: $2,468 (1012%)

Insurance Median: $1,753 (719%)

Cash: $2,468 (1012% of Medicare)

Ins. Median: $1,753 (719% 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 719% of the Medicare baseline (a markup of 619%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Unicare	$890	365%
Cdphp	$1,209 - $2,098	496%
Harvard Pilgrim	$1,254 - $1,668	514%
Blue Cross Blue Shield	$1,378 - $1,629	565%
United	$1,476 - $2,062	605%
Aetna	$1,481 - $2,069	608%
Mgb/Allways	$1,501 - $1,825	616%
Tufts Public Plan	$1,516 - $1,520	622%
United Ri Nj Ny	$1,555	638%
Ambetter / Centene	$1,560	640%
Carelon Strategies/Bhs	$1,604	658%
UnitedHealthcare	$1,604 - $2,098	658%
Carelon/Beacon	$1,851	759%
Fallon	$1,883 - $1,903	772%
Health New England	$1,994	818%
Cigna	$2,098 - $2,227	861%
Ets/Lifetrac	$2,098	861%
Interlink Transplant	$2,098	861%
Community Health Options	$2,221	911%
Humana	$2,221	911%
Coventry/Hcvm/First Health	$2,271	932%
Multiplan/Phcs	$2,271 - $2,345	932%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,468.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74176.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boston Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74176.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.