CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Medstar Good Samaritan Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $170
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Medstar Good Samaritan Hospital is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.70x the Medicare baseline. Located in 5601 Loch Raven Boulevard, Baltimore, MD.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $166 (68%)
Insurance Median: $170 (70%)
Cash: $166 (68% of Medicare)
Ins. Median: $170 (70% 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.

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
Aetna $170 70%
Amerigroup $170 70%
Amerihealth Caritas District Of Columbia $170 70%
Carefirst Advantage Inc $170 70%
Carefirst Blue Choice Inc $170 70%
Cigna $170 70%
First Health $170 70%
Hscsn $170 70%
Humana $170 70%
Kaiser Permanente $170 70%
Magellan Behavioral Health Inc $170 70%
Mamsi $170 70%
Medstar Family Choice $170 70%
Medstar Family Choice Inc $170 70%
Ncppo Healthlink Ppo $170 70%
Pfc $170 70%
Private Healthcare Systems (Phcs) $170 70%
Tricare $170 70%
United Behavioral Health Inc $170 70%
UnitedHealthcare $170 70%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5601 Loch Raven Boulevard, Baltimore, MD 21239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals