CT scan, abdomen and pelvis (no contrast)
Facility: Golden Valley Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $243
- Cash Discount Price: $2,663
- vs. Medicare Baseline: 1.00x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Home State Health | $219 | 90% |
| UnitedHealthcare | $219 - $413 | 90% |
| Aetna | $243 | 100% |
| Humana | $243 | 100% |
| Ambetter / Centene | $291 | 119% |
| Medica | $806 | 331% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important information to know upfront is that the cash median rate for this CT scan procedure is $2,663. While commercial insurance plans often negotiate higher rates due to administrative overhead and claim processing costs, self-pay patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce the final bill. It is also critical to verify your deductible status, as using insurance for shoppable tests without meeting your plan's accumulator balance can result in paying the full negotiated rate rather than a lower allowed amount.
When comparing this facility's pricing to broader benchmarks, the cash rate of $2,663 is notably higher than the state average for Missouri. Furthermore, the commercial negotiated rate varies by insurer, ranging from $219 with Home State Health to $806 with Medica, all of which are substantially lower than the facility's cash price. Under Medicare benchmarking principles, the federal government's fixed reimbursement rate of $243.77 serves as the objective baseline for evaluating hospital pricing markups; while commercial negotiated rates often average 200% to 300% of this Medicare rate, fair pricing is typically defined as 120% to 150%. In this specific case, the cash price exceeds the Medicare benchmark by a significant margin, highlighting that for patients with high-deductible plans, paying cash directly may be more cost-effective than relying on insurance coverage for this service.