CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Tri Valley Health System

Billing Code: 74176 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$914
about 3.7× the $244 Medicare rate · typically $239–$2,553
modeled estimate · not a bill or quote
Medicare pays $244 Fair price $914 Cash price $4,251 Hospital's list price $4,723

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $2,267 - $4,534 930%
Blue Cross Blue Shieldmajor $2,078 - $4,298 852%
Aetnamajor $4,629 1899%
Humanamajor $2,078 852%
Amerigroup $2,312 948%
Medica $2,078 - $4,251 852%
Molina $2,267 930%
WellCare $2,078 852%
+ 3 smaller / regional plans $2,182 - $2,267
Government programs also on file: Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1305 West Highway 6/34, Cambridge, NE 69022
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals