CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Licking Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $6,064
  • Cash Discount Price: $7,413
  • vs. Medicare Baseline: 24.88x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Licking Memorial Hospital is $6,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,413. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 24.88x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$7,413

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,064

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: $7,413 (3041%)
Insurance Median: $6,064 (2488%)
Cash: $7,413 (3041% of Medicare)
Ins. Median: $6,064 (2488% 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 2488% of the Medicare baseline (a markup of 2388%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Tricare $225 92%
Aetna $230 - $6,123 94%
Blue Cross Blue Shield $230 94%
Champva [500001] $230 94%
Cigna $230 - $6,672 94%
Humana $230 - $7,191 94%
Medicare (plans) $230 94%
UnitedHealthcare $230 - $6,301 94%
Veterans Administration [100068] $230 94%
Wellcare By Allwell [450104] $230 94%
Molina Marketplace [100106] $368 151%
Medical Mutual [100114] $4,077 - $6,153 1672%
Medben [700068] $5,189 - $7,265 2129%
Benicomp [70090] $5,560 2281%
Consociate Health 6 Degrees [100059] $5,930 2433%
Consociate Health [100029] $5,930 2433%
Allied Benefit Systems [100015] $6,064 2488%
Geha [100039] $6,064 2488%
Gravie Administrative Services [100165] $6,064 2488%
Meritain [100063] $6,064 2488%
Optima [700069] $6,064 2488%
Trustmark Small Business Benefits [100263] $6,064 2488%
Webtpa [100127] $6,064 2488%
Healthscope [100157] $6,301 2585%
Surest [100016] $6,301 2585%
United Medical Resources [700071] $6,301 2585%
American Postal Workers [100089] $6,672 2737%
Antidote Health Plan Of Ohio [70006803] $6,672 2737%
Coresource [100002] $6,672 - $7,413 2737%
Great West Life [700064] $6,672 2737%
National Association Of Letter Carriers [100067] $6,672 2737%
Ohio Healthy Luminare Health [100264] $6,672 2737%
Ohio Healthy [100255] $6,672 2737%
Ohio Ppo Connect [70006801] $6,672 2737%
Osu Prime Care [100254] $6,672 2737%
Quality Care Partners [70006802] $6,672 2737%
The Health Plan [100261] $6,672 2737%
Wellfleet Group, Llc [100164] $6,672 2737%
Coventry [100010] $6,842 2807%
Pan American Life [700070] $6,842 2807%
Ohio Health Choice [100109] $7,117 2920%
Administrative Concepts [100006] $7,191 2950%
Carefactor [100087] $7,191 2950%
Philadelphia American Life [100260] $7,191 - $7,413 2950%
Reliance Standard-Asrm [100258] $7,191 2950%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals