CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Hospital for Special Surgery

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $771
Cash Discount Price: $1,413
vs. Medicare Baseline: 3.16x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Hospital for Special Surgery is $771. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,413. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.16x the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$1,413

Average discount available for prompt cash payment at this facility.

Insurance Median

$771

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: $1,413 (580%)

Insurance Median: $771 (316%)

Cash: $1,413 (580% of Medicare)

Ins. Median: $771 (316% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 316% of the Medicare baseline (a markup of 216%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$62 - $1,183	25%
Fidelis	$65 - $69	27%
Blue Cross Blue Shield	$69 - $2,180	28%
Metro Plus	$87 - $91	36%
Emblem	$88 - $117	36%
Aetna	$94 - $210	39%
Affinity By Molina Health Plan [1005]	$94 - $1,124	39%
Christian Brothers [1034]	$94	39%
Connecticare [1039]	$94 - $2,180	39%
Emblem Health [1043]	$94 - $2,180	39%
Harvard Pilgrim [1057]	$94 - $1,183	39%
Medicare (plans)	$94	39%
Meritain Health [1085]	$94	39%
Nippon Life [1092]	$94	39%
Oxford [1096]	$94 - $823	39%
Student Resources [1103]	$94 - $1,030	39%
Webtpa [1356]	$94	39%
Nyship	$134	55%
Fidelis Essential [1323]	$156	64%
Cigna	$183 - $1,857	75%
Horizon	$216	89%
Apwu [1016]	$771 - $1,857	316%
Nalc [1090]	$771 - $1,857	316%
Qualcare [1101]	$771 - $1,857	316%
Wellfleet [1361]	$771 - $1,857	316%
Geha [1053]	$1,030	423%

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 $1,413.
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 Hospital for Special Surgery 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.