CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Highland Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $298
Cash Discount Price: $1,675
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Highland Hospital is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,675. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.22x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$1,675

Average discount available for prompt cash payment at this facility.

Insurance Median

$298

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: $1,675 (687%)

Insurance Median: $298 (122%)

Cash: $1,675 (687% of Medicare)

Ins. Median: $298 (122% 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
Amerigroup (Bswny Alternate) [1720]	$69	28%
Excellus [2201]	$69 - $555	28%
Medicaid / KanCare	$69 - $376	28%
Molina Healthcare [5189], Molina Healthcare [1723]	$69	28%
UnitedHealthcare	$69 - $479	28%
Mvp [2900]	$79 - $861	32%
Fidelis [5155]	$153 - $395	63%
Aetna	$174 - $491	71%
Elderplan [1316]	$174	71%
Excellus Bc/Bs [2201]	$174 - $326	71%
Icircle [1728]	$174	71%
Martins Point [1205]	$174 - $298	71%
Medicare (plans)	$174 - $396	71%
Nascentia [1729]	$174	71%
Humana	$176 - $366	72%
Highmark Bc/Bs Of Western Ny [5143]	$217 - $220	89%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$277 - $607	114%
Blue Cross Blue Shield	$298 - $424	122%
Independent Health [5156]	$320 - $387	131%
Cigna	$420 - $893	172%
Capital District Physicians Health Plan (Cdphp) [5149]	$467 - $624	192%

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 $1,675.
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 Highland Hospital 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.