CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Mercy Hospital Ada

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,051
Cash Discount Price: $3,292
vs. Medicare Baseline: 8.41x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Hospital Ada is $2,051. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,292. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.41x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$3,292

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,051

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: $3,292 (1350%)

Insurance Median: $2,051 (841%)

Cash: $3,292 (1350% of Medicare)

Ins. Median: $2,051 (841% 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 841% of the Medicare baseline (a markup of 741%). 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	$89 - $3,809	37%
Humana	$89 - $246	37%
Medicaid / KanCare	$89 - $332	37%
Blue Cross Blue Shield	$242	99%
Cherokee Nation Health Serv Contracted [320066]	$242	99%
Cross Timbers Hospice [20098]	$242	99%
Dept Of Veteran Affairs Contracted [320106]	$242	99%
Elara Caring Aspire Hospice Contracted [320433]	$242	99%
Elara Caring Aspire Hospice [20433]	$242	99%
Halo Hcr Inc Hospice Contracted [320432]	$242	99%
Halo Hcr Inc Hospice [20432]	$242	99%
Independent Health [20197]	$242	99%
Indian Health Service Contracted [320198]	$242	99%
Kindful Hospice Contracted [320434]	$242	99%
Kindful Hospice [20434]	$242	99%
Medical Associates Health [20444]	$242	99%
Medicare (plans)	$242 - $5,065	99%
Mercy Hospice Okc [20252]	$242	99%
Provider Partners Health Plans Contracted [320450]	$242	99%
Qual Choice Contracted [320325]	$242	99%
Tricare	$242	99%
UnitedHealthcare	$242 - $400	99%
Globalhealth Contracted [320145]	$246	101%
Cigna	$249	102%
Ambetter / Centene	$332	136%
Home State Health Plan Contracted [320187]	$332	136%
Novasys Contracted [320285]	$332	136%
United Medical Resources Contracted [320454]	$400 - $3,039	164%
Workers Comp [20426]	$409	168%
Medica Contracted [320239]	$439 - $5,065	180%
Health Choice Contracted [320166]	$544	223%
Healthsmart Preferred Care Contracted [320184]	$544	223%
Kempton Contracted [320214]	$544	223%
Healthcare Highways Plus Contracted [320175]	$1,975 - $3,799	810%
Webtpa Contracted [320417]	$2,127	873%
Osma Health Contracted [320292]	$2,279	935%
Benefit Management Contracted [320052]	$2,532 - $3,292	1039%
Aither Health Contracted [320449]	$3,039	1247%
Auxiant Contracted [320462]	$3,039	1247%
Ebms Contracted [320493]	$3,039	1247%
Federal Medical Center Contracted [320127]	$3,039	1247%
Healthlink Contracted [320179]	$3,039	1247%
Healthscope Contracted [320182]	$3,039	1247%
Imagine 360 Contracted [320494]	$3,039	1247%
Mercy Benefit Admin Contracted [320251]	$3,039 - $3,292	1247%
Point C Contracted [320238]	$3,039	1247%
Preferred Health Plan Contracted [320522]	$3,039	1247%
Quik Trip Contracted [320447]	$3,039	1247%
Reflect Health Contracted [320492]	$3,039	1247%
Show-Me Health Administrators Contracted [320483]	$3,039	1247%
Yuzu Health Contracted [320521]	$3,039	1247%
Globalhealth Contracted [320144]	$3,191	1309%
First Health Contracted [320128]	$4,209	1727%
Multiplan Contracted [320270]	$4,305	1766%
Private Health Care Systems Contracted [320320]	$4,305	1766%

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 $3,292.
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 Mercy Hospital Ada 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.