CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Hermann Area District Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,355
Cash Discount Price: $1,586
vs. Medicare Baseline: 5.56x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Hermann Area District Hospital is $1,355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,586. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.56x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$1,586

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,355

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: $1,586 (651%)

Insurance Median: $1,355 (556%)

Cash: $1,586 (651% of Medicare)

Ins. Median: $1,355 (556% 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 556% of the Medicare baseline (a markup of 456%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthlink Hmo	$515	211%
Care Partners Mcaid- All Plans	$562	231%
UnitedHealthcare	$585 - $1,268	240%
Healthlink Ppo - All Other Plans	$618	254%
Tricare	$897 - $1,196	368%
Choicecare Mcr Adv- All Plans	$952 - $1,268	391%
American Hlth Mcr Adv- All Plans	$997 - $1,329	409%
Blue Cross Blue Shield	$997 - $2,458	409%
Humana	$997 - $1,329	409%
Aetna	$1,017 - $2,869	417%
Wellcare Mcr Adv - All Plans	$1,017 - $1,355	417%
Cigna	$1,235 - $1,646	507%
Harmony Hp Mcaid- All Plans	$1,314 - $1,752	539%
Healthcare Usa Mcaid- All Plans	$1,473 - $1,963	604%
Ambetter / Centene	$1,595 - $2,126	654%
Multiplan/Phcs - All Plans	$1,700 - $2,265	697%
Coventry - All Plans	$1,926 - $2,567	790%
Comp Results - All Plans	$2,039 - $2,718	836%
Three Rivers - All Plans	$2,039 - $2,718	836%

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 $1,586.
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 Hermann Area District 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.