CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Adena Pike Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,211
Cash Discount Price: $1,527
vs. Medicare Baseline: 9.07x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Adena Pike Medical Center is $2,211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,527. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.07x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.

Cash / Self-Pay

$1,527

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,211

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: $1,527 (626%)

Insurance Median: $2,211 (907%)

Cash: $1,527 (626% of Medicare)

Ins. Median: $2,211 (907% 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 907% of the Medicare baseline (a markup of 807%). 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
Aetna	$733 - $2,486	301%
Blue Cross Blue Shield	$733 - $2,635	301%
Buckeye Community Health Plan	$733	301%
Humana	$733 - $2,901	301%
Medical Mutual Of Ohio	$733 - $1,941	301%
Medigold	$733	301%
Molina	$733	301%
Care Source	$748	307%
Gateway Health	$1,008	414%
Molina Marketplace	$1,202	493%
First Health	$1,250 - $2,394	513%
Care Source Just4Me	$1,319	541%
Sidecar Health	$2,015	827%
Ohio Ppo Connect	$2,138	877%
The Health Plan	$2,138	877%
Cigna	$2,211	907%
Medical Mutual Of Ohio Supermed	$2,301	944%
Ohio Health Choice	$2,431	997%
UnitedHealthcare	$2,626	1077%
Integrated Health Plan	$2,870	1177%
Healthsmart	$2,901	1190%
Multiplan/Private Healthcare Systems	$2,901	1190%
Three Rivers Network	$2,901	1190%

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 $1,527.
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 Adena Pike Medical Center 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.