CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Newton Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $376
  • Cash Discount Price: $264
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Newton Medical Center is $376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.54x the Medicare baseline. Located in 175 High St, Newton, NJ.
Cash / Self-Pay
$264

Average discount available for prompt cash payment at this facility.

Insurance Median
$376

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: $264 (108%)
Insurance Median: $376 (154%)
Cash: $264 (108% of Medicare)
Ins. Median: $376 (154% 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.

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
One Call Workers Comp [5418] $152 62%
Carisk Worker's Comp [5501] $160 66%
Cigna $185 - $264 76%
Evolution Healthcare [5438] $218 - $429 89%
Healthez [5445] $218 - $429 89%
Mvp Health Care [5197] $218 89%
Nalc [5198] $218 89%
Seafarers Health and Benefits Plan [5343] $218 89%
Tufts Health Plan [5344] $218 89%
Webtpa [5447] $218 - $429 89%
First Managed Care Option [5109] $226 - $8,425 93%
Allied Benefit Systems [5046] $240 - $429 98%
Centivo [5405] $240 - $541 98%
Iaa - Insurance Administrators of America [5482] $240 98%
Aetna $264 - $798 108%
Ambetter / Centene $264 108%
Amerihealth Administrators Supplemental [5512] $264 108%
Amerihealth Medigap [5049] $264 108%
Blue Cross Blue Shield $264 - $6,730 108%
Champva [5354] $264 108%
Claim Watcher/Homestead [5488] $264 - $4,956 108%
Claimdoc [5434] $264 108%
Cosmetic Surgery/Lap Band/Gastric Bypass [5289] $264 108%
Fairos [5491] $264 108%
Highmark Wholecare Health Plan Ip Splits [5464] $264 108%
Highmark Wholecare Health Plan [5413] $264 108%
Karen Ann Quinlan [5285] $264 108%
Luminare Health AHS Retiree [5013] $264 108%
Medicaid / KanCare $264 - $765 108%
Medicare (plans) $264 - $273 108%
Sedgwick Wtc Health Program Wc [5514] $264 108%
Specialty Imaging [5433] $264 108%
Tricare $264 108%
UPMC [5455] $264 108%
Us Family Health Plan [5258] $264 108%
VA Community Care Network [5403] $264 108%
Wellcare Behavioral Health [5335] $264 108%
Wellcare Health Plans Ip Splits [5475] $264 108%
Wellcare Health Plans [5269] $264 108%
Amerihealth Caritas Vip Care Ip Splits [5460] $267 110%
Amerihealth Caritas Vip Care [5313] $267 110%
Kindred Giralda Hospital [5341] $291 119%
Inservco Workers Compensation [5158] $303 - $8,425 124%
Medlogix/Consumer Health Network (Chn) [5415] $303 - $8,425 124%
Horizon Nj Health [5021] $322 132%
Independence Bc [5479] $336 138%
Prime Healthcare [5435] $336 138%
Wtc Health Program [5273] $351 144%
Qualcare [5026] $365 - $936 150%
Apwu Healthcare [5053] $376 154%
Geha [5119] $376 154%
Golden Rule Insurance [5124] $376 154%
Harvard Pilgrim Healthcare [5133] $376 154%
Ntca [5208] $376 154%
Oxford Behavioral Health [5291] $376 154%
Oxford [5024] $376 154%
Surest [5437] $376 154%
UnitedHealthcare $376 154%
Gallagher Bassett Workers Comp [5117] $383 157%
Liberty Mutual Worker's Comp [5174] $383 157%
Pma Workers Comp [5224] $383 157%
Sedgwick [5235] $383 157%
Sentry Worker's Comp [5489] $383 157%
Travelers Workers Compensation [5250] $383 157%
Praxis Workers Comp [5515] $400 - $7,434 164%
Occunet [5490] $424 174%
The Fairly Group [5528] $424 174%
1199 Seiu Benefit and Pension [5037] $429 176%
Banner Health Network [5510] $429 176%
Boon-Chapman [5441] $429 176%
Christian Brothers Services [5439] $429 176%
Continental Assurance [5091] $429 176%
Healthsmart Benefit Solutions [5446] $429 176%
Luminare Health Benefits [5483] $429 176%
Marpai Health [5449] $429 176%
Meritain Health [5185] $429 176%
Nippon Benefit Life [5201] $429 176%
Starmark [5240] $429 176%
Untd Hlth Community Plan Behavioral Health [5293] $732 300%
Untd Hlth Community Plan [5034] $732 300%
High Point No Fault [5146] $764 313%
Medlogix/Consumer Health Network Pip (Chn) [5414] $764 313%
Plymouth Rock Assurance No Fault [5222] $764 313%
Ghi Emblem Health [5122] $936 384%
Humana $936 384%
Ila Local 1478-2 Welfare Fund [5448] $936 384%
Oscar [5213] $936 384%
Magnacare [5177] $1,235 - $7,930 507%
Amerihealth [5008] $5,352 2196%
Continental Assurance - PHCS [5092] $5,452 2237%
Continental Casualty PHCS [5094] $5,452 2237%
Coresource [5014] $5,452 2237%
Kaiser Permanente [5162] $5,452 2237%
Private Healthcare Systems PPO (PHCS) [5227] $5,452 2237%
Church Mutual Wc Insurance Company [5524] $5,590 2293%
Hanover Workers Comp [5130] $5,590 2293%
Hartford Worker's Compensation [5132] $5,590 2293%
Hcs Network Solutions [5148] $5,590 2293%
Nj Manufacturers Workers Comp [5204] $5,590 2293%
Selective Ins Workers Comp [5237] $5,590 2293%
Strategic Comp [5518] $5,590 2293%
Zurich Workers Comp [5275] $5,590 2293%
Allstate [5047] $5,917 2427%
Esurance No Fault [5105] $5,917 2427%
Geico No Fault [5120] $5,917 2427%
Hanover No Fault [5129] $5,917 2427%
Liberty Mutual No Fault [5173] $5,917 2427%
Nj Manufacturers No Fault [5203] $5,917 2427%
Progressive No Fault [5229] $5,917 2427%
State Farm No Fault [5241] $5,917 2427%
Travelers No Fault [5249] $5,917 2427%
Usaa No Fault [5260] $5,917 2427%
Zurich No Fault [5274] $5,917 2427%
Occunet Secondary [5517] $5,947 2440%
The Fairly Group Secondary [5531] $5,947 2440%
First Health Network [5108] $6,443 2643%
Multiplan [5194] $6,938 2846%
Aig Workers Compensation [5045] $7,434 3050%
Amtrust North America Inc [5521] $7,434 3050%
Berkshire Hathaway Guard Insurance Company [5529] $7,434 3050%
Broadspire Workers Comp [5357] $7,434 3050%
Ccmsi Wc [5525] $7,434 3050%
Nationwide Mutual Insurance Company [5526] $7,434 3050%
Qual-Lynx Wc Preferred [5230] $7,434 3050%
Qual-Lynx Wc Standard [5028] $7,434 3050%
Sage Adjusting, LLC [5527] $7,434 3050%
Chubb Worker's Compensation [5075] $8,425 3456%
Claims Resolution Corporation Inc [5520] $8,425 3456%
Corvel Corporation [5522] $8,425 3456%
Esis [5519] $8,425 3456%
Medrisk/Spnet Worker's Comp [5452] $8,425 3456%
Atlantic Home Care and Hospice [5055] $9,912 4066%
Bundled Cases/Episodic Payment [5492] $9,912 4066%
Carba R Generic [5530] $9,912 4066%
Kessler Foundation [5532] $9,912 4066%
Streamline Worker's Comp [5540] $9,912 4066%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 175 High St, Newton, NJ 07860
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals