CMS Price Transparency Data
CT scan, abdomen and pelvis (no contrast)
Facility: Mercy Health Saint Mary's
Billing Code: 74176 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74176
- Insurance Median: $1,924
- Cash Discount Price: $1,713
- vs. Medicare Baseline: 7.89x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Health Saint Mary's is $1,924. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,713. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.89x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$1,713
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,924
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: $1,713 (703%)
Insurance Median: $1,924 (789%)
Cash: $1,713 (703% of Medicare)
Ins. Median: $1,924 (789% 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 789% of the Medicare baseline (a markup of 689%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $129 - $233 | 53% |
| Geha | $129 - $2,003 | 53% |
| Medical Mutual | $129 | 53% |
| Meritain | $129 | 53% |
| Preferred One | $129 | 53% |
| Blue Cross Blue Shield | $133 - $233 | 55% |
| Medicaid / KanCare | $133 - $136 | 55% |
| Access Health | $166 | 68% |
| Bcn Domestic | $167 | 69% |
| Blue Benefit Administrators Of Massachusetts | $167 | 69% |
| Blue Care Network | $167 | 69% |
| Blue Distinction Transplant | $167 | 69% |
| Blue Shield - Ca | $167 | 69% |
| Blue Shield - Id (Regence) | $167 | 69% |
| Blue Shield - Ny Highmark Northeastern | $167 | 69% |
| Blue Shield - Ny Highmark Western | $167 | 69% |
| Blue Shield - Pa (Highmark) | $167 | 69% |
| Blue Shield - Wa (Regence) | $167 | 69% |
| Health Choices | $167 - $2,006 | 69% |
| Kaiser Domestic | $167 | 69% |
| Blue Care Network Advantage | $233 | 96% |
| Medicare (plans) | $233 | 96% |
| Align Senior Care | $238 | 98% |
| Correctional Recovery | $238 | 98% |
| Hospice Faith | $238 | 98% |
| Hospice Of Holland | $238 | 98% |
| UnitedHealthcare | $245 - $2,636 | 101% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $268 | 110% |
| Oscar | $304 | 125% |
| Molina Marketplace | $309 | 127% |
| Vitalcore | $368 | 151% |
| Wellpath | $368 | 151% |
| U Of M Health Plan | $410 - $2,006 | 168% |
| Priority Health | $562 - $577 | 231% |
| Wc Accident Fund | $1,440 | 591% |
| Wc Advantage | $1,440 | 591% |
| Wc Aig | $1,440 | 591% |
| Wc Allied | $1,440 | 591% |
| Wc Amerisure | $1,440 | 591% |
| Wc Amtrust | $1,440 | 591% |
| Wc Asu Risk Mgt | $1,440 | 591% |
| Wc Berkley Admin | $1,440 | 591% |
| Wc Broadspire | $1,440 | 591% |
| Wc Bunch & Associates | $1,440 | 591% |
| Wc Ccmsi | $1,440 | 591% |
| Wc Emc Insurance Company | $1,440 | 591% |
| Wc Esis | $1,440 | 591% |
| Wc Fcci | $1,440 | 591% |
| Wc Federated | $1,440 | 591% |
| Wc Gallagher Bassett | $1,440 | 591% |
| Wc Genex Care For Ohio | $1,440 | 591% |
| Wc Guard Insurance Company | $1,440 | 591% |
| Wc Hartford | $1,440 | 591% |
| Wc Liberty Mutual | $1,440 | 591% |
| Wc Meijers | $1,440 | 591% |
| Wc Michigan | $1,440 | 591% |
| Wc Mitchell Frankenmuth | $1,440 | 591% |
| Wc Pma | $1,440 | 591% |
| Wc Sedgwick | $1,440 | 591% |
| Wc Sentry | $1,440 | 591% |
| Wc Travelers | $1,440 | 591% |
| Wc Tristar | $1,440 | 591% |
| Wc Walmart | $1,440 | 591% |
| Wc Zurich | $1,440 | 591% |
| Nomi Health | $1,476 | 605% |
| Acs Benefit Services | $1,516 | 622% |
| Allied Benefit Systems | $1,516 | 622% |
| Claimchoice Adminstrators | $1,516 | 622% |
| Consociate | $1,516 | 622% |
| Cypress Benefit Administrators | $1,516 | 622% |
| Forest County Potawatomi | $1,516 | 622% |
| Health Smart | $1,516 | 622% |
| Healthgram | $1,516 | 622% |
| Healthscope | $1,516 | 622% |
| Secureone Preferred United Plans | $1,516 | 622% |
| Sisco Benefits | $1,516 | 622% |
| The Health Plan | $1,516 | 622% |
| Trustmark Small Business Benefits | $1,516 | 622% |
| Unified Group Services | $1,516 | 622% |
| Webtpa | $1,516 | 622% |
| Asr Health Benefits | $1,677 | 688% |
| Hap | $1,677 - $2,044 | 688% |
| Varipro | $1,713 | 703% |
| Caresource | $1,722 | 706% |
| Cigna | $1,923 | 789% |
| 1199 National Benefit Fund | $1,924 | 789% |
| Allied National Global Care | $1,924 | 789% |
| Asrm - Reliance Standard Life Insurance | $1,924 | 789% |
| Christian Care Ministry | $1,924 | 789% |
| Dean Health | $1,924 | 789% |
| Fallon Health | $1,924 | 789% |
| Family Life Insurance Company | $1,924 | 789% |
| Ghc Scw | $1,924 | 789% |
| Group Pension Administrators | $1,924 | 789% |
| International Benefit Administrators | $1,924 | 789% |
| Lifetime Benefit Solutions | $1,924 | 789% |
| Manhattan Life | $1,924 | 789% |
| Medi Share | $1,924 | 789% |
| Multiplan | $1,924 | 789% |
| Mvp | $1,924 | 789% |
| Pai | $1,924 | 789% |
| Pan-American Life | $1,924 | 789% |
| Paramount Hmo | $1,924 | 789% |
| Phcs | $1,924 | 789% |
| Trinity Health Share | $1,924 | 789% |
| Acclaim | $2,006 | 823% |
| Administrative Concepts | $2,006 | 823% |
| Allegeant | $2,006 | 823% |
| Ameriben | $2,006 | 823% |
| American Family | $2,006 | 823% |
| American Healthcare Alliance | $2,006 | 823% |
| American Republic | $2,006 | 823% |
| Amerihealth | $2,006 | 823% |
| Aultcare | $2,006 | 823% |
| Automated Benefit Services | $2,006 | 823% |
| Auxiant | $2,006 | 823% |
| Benefit Administrative Systems,Llc | $2,006 | 823% |
| Boon Chapman | $2,006 | 823% |
| Cam Administrative Services | $2,006 | 823% |
| Christian Brother Services | $2,006 | 823% |
| Christian Brothers Holy Cross | $2,006 | 823% |
| Comprehensive Benefits | $2,006 | 823% |
| Continental Life Insurance | $2,006 | 823% |
| Custom Benefit Administrators | $2,006 | 823% |
| Employee Benefit Concepts | $2,006 | 823% |
| Employee Benefit Management | $2,006 | 823% |
| Enterprise Group Planning | $2,006 | 823% |
| Freedom Life Insurance Company | $2,006 | 823% |
| Group Administrators | $2,006 | 823% |
| Group Marketing Services | $2,006 | 823% |
| Guardian | $2,006 | 823% |
| Health America | $2,006 | 823% |
| Healthez | $2,006 | 823% |
| Humana | $2,006 - $2,636 | 823% |
| Insight | $2,006 | 823% |
| Intercare | $2,006 | 823% |
| Jfp Benefit Management | $2,006 | 823% |
| Jp Farley Corporation | $2,006 | 823% |
| Key Benefit Administrator | $2,006 | 823% |
| Liberty Union Life Assurance Co | $2,006 | 823% |
| Lucent Health | $2,006 | 823% |
| Luminare Health | $2,006 | 823% |
| Luminare Health (Detroit) | $2,006 | 823% |
| Medben | $2,006 | 823% |
| Medcost | $2,006 | 823% |
| Mutual Health Services | $2,006 | 823% |
| Mutual Of Omaha | $2,006 | 823% |
| Ncas | $2,006 | 823% |
| Nippon Life Ins | $2,006 | 823% |
| Nova | $2,006 | 823% |
| Painters Union Insurance Fund | $2,006 | 823% |
| Physicians Mutual | $2,006 | 823% |
| Plumbers Local 98 Insurance Fund | $2,006 | 823% |
| Prairie States | $2,006 | 823% |
| Primary Physician Care | $2,006 | 823% |
| Professional Benefit Administrators | $2,006 | 823% |
| The Loomis Company | $2,006 | 823% |
| Unicare | $2,006 | 823% |
| Us Health And Life | $2,006 | 823% |
| Valenz | $2,006 | 823% |
| Western & Southern Financial Group | $2,006 | 823% |
| Wps | $2,006 | 823% |
| Coventry | $2,088 | 857% |
| First Health | $2,088 | 857% |
| Cmh Allegan County | $2,636 | 1081% |
| Cmh Ausable Valley | $2,636 | 1081% |
| Cmh Barry County | $2,636 | 1081% |
| Cmh Berrien County | $2,636 | 1081% |
| Cmh Cass County | $2,636 | 1081% |
| Cmh Clinton-Eaton-Ingham County | $2,636 | 1081% |
| Cmh Kalamazoo | $2,636 | 1081% |
| Cmh Kent County | $2,636 | 1081% |
| Cmh Lenawee County | $2,636 | 1081% |
| Cmh Misc | $2,636 | 1081% |
| Cmh Monroe County | $2,636 | 1081% |
| Cmh Montcalm County | $2,636 | 1081% |
| Cmh Muskegon County | $2,636 | 1081% |
| Cmh Newaygo County | $2,636 | 1081% |
| Cmh North Country | $2,636 | 1081% |
| Cmh Northern Lakes County | $2,636 | 1081% |
| Cmh Ottawa County | $2,636 | 1081% |
| Cmh Van Buren County | $2,636 | 1081% |
| Cmh West Mi County | $2,636 | 1081% |
| Magellan Behavioral Health | $2,636 | 1081% |