CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: M Health Fairview St John's Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $280
Cash Discount Price: $514
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at M Health Fairview St John's Hospital is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $514. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.15x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$514

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $514 (211%)

Insurance Median: $280 (115%)

Cash: $514 (211% of Medicare)

Ins. Median: $280 (115% 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
Health Partners	$57 - $1,359	23%
Primewest	$57 - $235	23%
South Country Health Alliance	$57 - $235	23%
Ucare	$58 - $540	24%
Medica	$60 - $841	25%
Blue Cross Blue Shield	$65 - $640	27%
Itasca Medical Care	$65 - $235	27%
Sanford Health Plan	$77 - $758	32%
Security Health Plan	$77 - $965	32%
UnitedHealthcare	$77 - $718	32%
Wellcare	$77 - $235	32%
Hennepin Health	$87 - $246	36%
America'S Ppo	$664 - $926	272%
First Health	$1,045 - $1,055	429%
Multiplan	$1,084 - $1,093	445%
Private Healthcare Systems	$1,084 - $1,093	445%
Wisconsin Physician Services	$1,147 - $1,158	471%

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 $514.
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 M Health Fairview St John'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.