CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Bertrand Chaffee Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $113
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Bertrand Chaffee Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.46x the Medicare baseline. Located in 224 East Main Street, Springville, NY.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $193 (79%)
Insurance Median: $113 (46%)
Cash: $193 (79% of Medicare)
Ins. Median: $113 (46% 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
Comm Blue Essential $42 17%
Community Blue $42 17%
Community Care - Bc $42 17%
Fidelis Care Of New York $42 17%
Ghi Medical $42 17%
Gowanda Correctional Fac $42 17%
Medicaid / KanCare $42 17%
Molina Essential Plan $42 17%
Molina Heathcare Of Wny $42 17%
Seneca Nation Health Dept $42 17%
United Hc - Community Pln $42 17%
United Hc Essential Plan $42 17%
Univera Hc Myhealth $42 17%
Univera Hc Myhealth+ $42 - $157 17%
Yourcare $42 17%
Fidelis Essential Plans $94 39%
Private Pay $94 - $293 39%
Aetna $110 - $345 45%
American Progressive Ins. $110 - $345 45%
Cigna $110 - $345 45%
Commercial / Misc $110 - $345 45%
Global Excel Mgt $110 - $345 45%
Guardian Life Ins. Co. $110 - $345 45%
Mvp Commercial $110 - $345 45%
No Amer Meritian Health $110 - $345 45%
No-Fault $110 - $345 45%
Blue Cross Blue Shield $113 - $122 46%
Senior Blue - Bc $113 46%
Univera Essential Plans $157 64%
Univera Hc Child Health+ $157 64%
Univera Plus Med $157 64%
Iha Essential Plans $179 - $183 73%
Iha Medisource $179 - $183 73%
Univera Senior Choice $185 76%
Univera Healthcare $222 91%
Iha Encompass 65 $254 104%
Iha $287 118%
Iha Custom Coverage $287 118%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 224 East Main Street, Springville, NY 14141
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals