CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Lafayette Regional Health Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $3,596
  • Cash Discount Price: $8,563
  • vs. Medicare Baseline: 14.75x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Lafayette Regional Health Center is $3,596. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,563. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.75x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$8,563

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,596

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: $8,563 (3513%)
Insurance Median: $3,596 (1475%)
Cash: $8,563 (3513% of Medicare)
Ins. Median: $3,596 (1475% 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 1475% of the Medicare baseline (a markup of 1375%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
United $131 - $3,853 54%
Healthyblue $134 55%
Medicaid / KanCare $135 55%
Aetna $136 - $7,492 56%
Amerigroup $136 56%
Home State Health Plan $136 56%
Unicare $136 56%
Corvel Corporation $181 - $7,278 74%
Oha Network $183 - $4,281 75%
Ambetter / Centene $1,593 653%
Nhc Advantage $1,627 667%
Universal Healthcare $2,226 913%
Humana $2,894 - $3,682 1187%
Blue Cross Blue Shield $3,254 - $8,563 1335%
College Park Family Care Center $3,682 1510%
Oscar $4,281 1756%
Cigna $4,891 - $6,114 2006%
Wppa Providrs Care Network $6,422 2634%
Multiplan $6,679 2740%
Coventry $6,833 2803%
Coventry Kc Mo $6,833 2803%
Cco, Inc. $7,278 2986%
Focus Healthcare Mgmt, Inc $7,706 3161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals