CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Cheshire Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $389
Cash Discount Price: $601
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Cheshire Medical Center is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $601. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.60x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$601

Average discount available for prompt cash payment at this facility.

Insurance Median

$389

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: $601 (247%)

Insurance Median: $389 (160%)

Cash: $601 (247% of Medicare)

Ins. Median: $389 (160% 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.

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	$77 - $2,395	32%
Ambetter / Centene	$86 - $225	35%
Blue Cross Blue Shield	$86 - $2,782	35%
Cigna	$86 - $1,733	35%
Martin'S Point Generations Advantage	$86 - $253	35%
Martin'S Point Health Care	$86 - $253	35%
Mvp	$86 - $1,733	35%
UnitedHealthcare	$86 - $2,658	35%
Wellcare Health Plans	$86 - $253	35%
Wellsense Health Plan	$86 - $483	35%
Amerihealth Caritas Nh	$105 - $429	43%
Granite State Health Plan	$106 - $585	43%
Harvard Pilgrim Health Care Of Ne	$182 - $1,592	75%
Mass General Brigham Health Plan	$212 - $3,502	87%
Tufts Health Plan	$243 - $2,235	100%
Maine Community Health Options	$385 - $1,576	158%
First Health/Hcvm	$727 - $2,977	298%
Phcs	$770 - $3,152	316%

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 $601.
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 Cheshire Medical Center 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.