CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $435
Cash Discount Price: $2,167
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Memorial Hospital is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,167. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.78x the Medicare baseline. Located in 715 South Taft Avenue, Fremont, OH.

Cash / Self-Pay

$2,167

Average discount available for prompt cash payment at this facility.

Insurance Median

$435

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: $2,167 (889%)

Insurance Median: $435 (178%)

Cash: $2,167 (889% of Medicare)

Ins. Median: $435 (178% 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
Meridian Health Plan Of Mi	$131 - $1,316	54%
Aetna	$162 - $2,094	66%
Summacare	$162 - $1,834	66%
Paramount Healthcare Inc	$165 - $1,867	68%
Blue Cross Blue Shield	$168 - $1,183	69%
Buckeye Community Health Plan	$170 - $972	70%
Frontpath	$170 - $2,037	70%
Health Alliance Plan	$170 - $2,167	70%
Humana	$170 - $1,316	70%
Molina Healthcare Of Ohio	$170 - $2,024	70%
Caresource	$172 - $772	71%
UnitedHealthcare	$186 - $754	76%
Cigna	$193 - $2,324	79%
Health Ohio Network	$234 - $2,300	96%
Amerihealth	$282 - $526	116%
Medical Mutual Of Ohio	$550 - $2,227	226%
Multiplan	$550 - $3,001	226%

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 $2,167.
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 Memorial 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.