CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Garnet Health Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $426
Cash Discount Price: $478
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Garnet Health Medical Center is $426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.75x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.

Cash / Self-Pay

$478

Average discount available for prompt cash payment at this facility.

Insurance Median

$426

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: $478 (196%)

Insurance Median: $426 (175%)

Cash: $478 (196% of Medicare)

Ins. Median: $426 (175% 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
Magnacare	$297 - $475	122%
Aetna	$298 - $426	122%
Fidelis	$304	125%
Wellcare	$305	125%
UnitedHealthcare	$374	153%
Mvp	$384	158%
Local 1199	$426	175%
Rojw	$521	214%
Emblem Health	$548	225%
Northwell Direct	$611	251%
Geisinger Health Plan	$745	306%
Blue Cross Blue Shield	$771 - $1,127	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 $478.
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 Garnet Health 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.