CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Highlands Cashiers Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $3,446
Cash Discount Price: $7,710
vs. Medicare Baseline: 14.14x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Highlands Cashiers Hospital is $3,446. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,710. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.14x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.

Cash / Self-Pay

$7,710

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,446

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: $7,710 (3163%)

Insurance Median: $3,446 (1414%)

Cash: $7,710 (3163% of Medicare)

Ins. Median: $3,446 (1414% 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 1414% of the Medicare baseline (a markup of 1314%). 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
Apex Health	$1,542	633%
Cigna	$2,529 - $3,423	1037%
Blue Cross Blue Shield	$2,624 - $2,776	1076%
United	$2,663 - $4,672	1092%
Wellcare	$2,702	1108%
Amerihealth	$2,728	1119%
Partners Health Management	$2,755	1130%
Vaya Health	$2,755	1130%
Amerihealth Caritas	$2,930	1202%
Caresource	$3,392	1391%
Medcost	$3,616 - $4,350	1483%
Aetna	$3,701 - $5,605	1518%
Magellan	$4,626	1898%
Magellan Behavioral Health	$4,626	1898%
Multiplan	$6,168	2530%
Avalon Administrative Services	$6,553	2688%
Prime Health	$6,785 - $6,939	2783%

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 $7,710.
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 Highlands Cashiers 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.