CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $174
Cash Discount Price: $2,261
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at The University of Vermont Health Network-Alice Hy is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,261. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.71x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$2,261

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $2,261 (928%)

Insurance Median: $174 (71%)

Cash: $2,261 (928% of Medicare)

Ins. Median: $174 (71% 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
Capital District Physicians' Health Plan	$53 - $4,151	22%
UnitedHealthcare	$54 - $4,353	22%
Blue Cross Blue Shield	$63 - $1,414	26%
Fidelis Care	$66 - $1,414	27%
Humana	$66 - $1,414	27%
Mvp	$66 - $1,414	27%
Aetna	$78 - $3,800	32%
Martins Point	$78 - $1,414	32%
Veterans Affairs Community Care Network	$78 - $1,414	32%
Choicecare	$82 - $3,314	34%
Magnacare	$82 - $3,535	34%
Highmark Blueshield	$101 - $3,959	41%
St. Regis	$186 - $1,414	76%

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 $2,261.
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 The University of Vermont Health Network-Alice Hy 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.