CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $238
Cash Discount Price: $2,445
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Munson Healthcare Otsego Memorial Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,445. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$2,445

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $2,445 (1003%)

Insurance Median: $238 (98%)

Cash: $2,445 (1003% of Medicare)

Ins. Median: $238 (98% 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.

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
Mclaren Health Plan	$52 - $2,466	21%
Meridian	$52 - $124	21%
Molina	$52 - $257	21%
Priority Health	$52 - $361	21%
UnitedHealthcare	$52 - $2,356	21%
Blue Cross Blue Shield	$53 - $1,837	22%
Blue Care Network	$78 - $238	32%
Hap (Health Alliance Plan)	$78 - $2,353	32%
Humana	$78 - $238	32%
Medicare (plans)	$78 - $238	32%
Michigan Amish Medical Board	$78 - $238	32%
Northern Michigan Mennonite Group	$78 - $238	32%
Aetna	$79 - $2,382	32%
Asr Physicians Care Network	$118 - $2,353	48%
Cigna	$123 - $361	50%
Nomi Health	$126 - $2,353	52%
Employee Benefit Logistics	$133 - $404	55%
Munson Hospice	$852 - $2,059	350%
Hospice Of Michigan	$1,688 - $1,765	692%
Enterprise Group Planning/Employee Benefit Plan	$2,250 - $2,353	923%
Cofinity	$2,391 - $2,500	981%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$2,391 - $2,500	981%
Three Rivers Provider Network	$2,391 - $2,500	981%

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 $2,445.
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 Munson Healthcare Otsego Memorial 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.