CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Kaleida Health

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $163
  • Cash Discount Price: $821
  • vs. Medicare Baseline: 0.67x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Kaleida Health is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $821. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.67x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
$821

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $821 (337%)
Insurance Median: $163 (67%)
Cash: $821 (337% of Medicare)
Ins. Median: $163 (67% 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
Univera Healthcare $41 - $136 17%
American Progressive Life & Health $63 - $78 26%
Fidelis Care $63 - $163 26%
UnitedHealthcare $65 - $323 27%
Highmark Wny $66 - $99 27%
Amerihealth Caritas Pennsylvania $67 27%
Molina Healthcare Of New York, Inc. $68 - $163 28%
Humana $72 - $76 30%
Emblemhealth - Hip $73 30%
Wellcare $84 - $310 34%
Mvp Healthplan $89 - $108 37%
Ambetter / Centene $101 41%
Ghi/Emblem Health $116 - $402 48%
Ghi/Emblem Health - Wchob $116 - $144 48%
Aetna $120 - $316 49%
Magnacare $120 - $154 49%
Magnacare - Wchob $120 - $154 49%
Univera $153 - $415 63%
Univera - Wchob $153 - $404 63%
Independent Health Association $173 - $554 71%
Independent Health Association - Wchob $180 - $554 74%
Blue Cross Blue Shield $203 - $1,111 83%
Tricare $283 116%
Fidelis $322 132%
Cigna $348 - $423 143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals