CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Helen Newberry Joy Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $193
Cash Discount Price: $123
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Helen Newberry Joy Hospital is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.79x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $123 (50%)

Insurance Median: $193 (79%)

Cash: $123 (50% of Medicare)

Ins. Median: $193 (79% 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
Mi Wc - All Plans	$76 - $1,832	31%
Aetna	$107 - $2,720	44%
Uphg Tpa - All Plans	$107 - $2,577	44%
First Health - All Plans	$113 - $2,720	46%
Ppom/Cofinity - All Plans	$113 - $2,720	46%
Cigna	$116 - $2,777	48%
Health Alliance - All Plans	$116 - $2,777	48%
Healtheos - All Plans	$116 - $2,777	48%
Priority Health - All Plans	$116 - $2,777	48%
UnitedHealthcare	$116 - $2,777	48%
Vital Core - All Plans	$116 - $2,778	48%
Blue Cross Blue Shield	$118 - $2,827	48%
Uphp Mcaid - All Plans	$229 - $1,346	94%
Va - All Plans	$253 - $1,174	104%
Humana	$321 - $1,145	132%
Mi Health Link - All Plans	$321 - $1,145	132%

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 $123.
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 Helen Newberry Joy 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.