CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Lexington Memorial Hospital Inc

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,688
Cash Discount Price: $1,895
vs. Medicare Baseline: 6.92x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Lexington Memorial Hospital Inc is $1,688. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,895. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.92x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$1,895

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,688

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: $1,895 (777%)

Insurance Median: $1,688 (692%)

Cash: $1,895 (777% of Medicare)

Ins. Median: $1,688 (692% 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 692% of the Medicare baseline (a markup of 592%). 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
Amerihealth	$714 - $1,041	293%
Carolina Complete	$714	293%
Healthy Blue	$714	293%
Partners	$714	293%
UnitedHealthcare	$721 - $1,698	296%
Vaya	$721	296%
Wellcare	$721	296%
Alliance	$728	299%
Trillium	$736	302%
Medcost	$830 - $2,536	340%
Blue Cross Blue Shield	$1,057 - $1,697	434%
Aetna	$1,076 - $3,502	441%
Ambetter / Centene	$1,088	446%
Oscar	$1,213 - $1,668	498%
Cigna	$1,649 - $1,679	676%
Directnet	$2,240	919%
Healthgram Lexington Home Brands	$2,729	1119%
Healthgram	$3,032	1244%
Private Healthcare Systems	$3,108	1275%
Beechstreet	$3,335	1368%
Humana	$3,335	1368%
Multiplan	$3,411	1399%
National Provider Network	$3,411	1399%

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 $1,895.
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 Lexington Memorial Hospital Inc 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.