CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Mercy Hospital Carthage

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,627
Cash Discount Price: $1,926
vs. Medicare Baseline: 6.67x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Hospital Carthage is $1,627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,926. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.67x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,926

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,627

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: $1,926 (790%)

Insurance Median: $1,627 (667%)

Cash: $1,926 (790% of Medicare)

Ins. Median: $1,627 (667% 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 667% of the Medicare baseline (a markup of 567%). 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
Aetna	$89 - $2,637	37%
Humana	$89 - $889	37%
Medicaid / KanCare	$89 - $1,627	37%
Blue Cross Blue Shield	$131 - $814	54%
Medicare (plans)	$226 - $877	93%
UnitedHealthcare	$317 - $2,578	130%
Cherokee Nation Health Serv Contracted [320066]	$814	334%
Cigna	$814 - $2,667	334%
Cross Timbers Hospice [20098]	$814	334%
Dept Of Veteran Affairs Contracted [320106]	$814	334%
Elara Caring Aspire Hospice [20433]	$814	334%
Globalhealth Contracted [320145]	$814	334%
Halo Hcr Inc Hospice Contracted [320432]	$814	334%
Halo Hcr Inc Hospice [20432]	$814	334%
Indian Health Service Contracted [320198]	$814	334%
Kindful Hospice Contracted [320434]	$814	334%
Kindful Hospice [20434]	$814	334%
Medical Associates Health Contracted [320444]	$814	334%
Mercy Hospice Okc [20252]	$814	334%
Mercy Mgd Behavioral Health Contracted [320259]	$814	334%
Pace Of The Ozarks Contracted [320518]	$814	334%
Provider Partners Health Plans Contracted [320450]	$814	334%
Qual Choice Contracted [320325]	$814	334%
Tricare	$817	335%
United Medical Resources Contracted [320454]	$1,031 - $2,667	423%
Point C Contracted [320238]	$1,037 - $2,667	425%
Health Systems Inc Contracted [320174]	$1,274	523%
Insurance System Inc Contracted [320465]	$1,274	523%
Administrative Payor Contracted [320005]	$1,333	547%
Centivo Contracted [320505]	$1,363	559%
Healthscope Contracted [320182]	$1,544	633%
Ambetter / Centene	$1,627	667%
Home State Health Plan Contracted [320187]	$1,627	667%
Novasys Contracted [320285]	$1,627	667%
Benefit Management Contracted [320052]	$1,778 - $2,578	729%
Auxiant Contracted [320462]	$1,926 - $2,519	790%
Healthlink Contracted [320179]	$1,926 - $2,756	790%
Preferred Health Plan Contracted [320522]	$1,926	790%
Workers Comp [20426]	$2,370 - $2,963	972%
90 Degree Benefits Contracted [320436]	$2,519	1033%
Aither Health Contracted [320449]	$2,519	1033%
Ebms Contracted [320493]	$2,519	1033%
Edison Health Solutions Contracted [320502]	$2,519	1033%
Imagine 360 Contracted [320494]	$2,519	1033%
Mercy Benefit Admin Contracted [320251]	$2,519 - $2,667	1033%
Reflect Health Contracted [320492]	$2,519	1033%
Show-Me Health Administrators Contracted [320483]	$2,519	1033%
Yuzu Health Contracted [320521]	$2,519	1033%
Medica Contracted [320239]	$2,566	1053%
Evolutions Health Care Contracted [320124]	$2,578	1058%
First Health Contracted [320128]	$2,578	1058%
Multiplan Contracted [320270]	$2,578	1058%
Private Health Care Systems Contracted [320320]	$2,578	1058%
American Healthcare Alliance Contracted [320020]	$2,667	1094%
Ppo Plus Contracted [320310]	$2,667	1094%
Usa Managed Care Org Contracted [320429]	$2,667	1094%

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 $1,926.
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 Mercy Hospital Carthage 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.