CMS Price Transparency Data
CT scan, abdomen and pelvis (no contrast)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 74176 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74176
- Insurance Median: $964
- Cash Discount Price: $2,088
- vs. Medicare Baseline: 3.95x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Saint Alphonsus Medical Center Ontario is $964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,088. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.95x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$2,088
Average discount available for prompt cash payment at this facility.
Insurance Median
$964
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: $2,088 (857%)
Insurance Median: $964 (395%)
Cash: $2,088 (857% of Medicare)
Ins. Median: $964 (395% 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 395% of the Medicare baseline (a markup of 295%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $145 - $964 | 59% |
| Blue Cross Blue Shield | $278 - $2,730 | 114% |
| Medicare (plans) | $278 - $298 | 114% |
| UnitedHealthcare | $278 - $3,084 | 114% |
| Aetna | $287 - $3,042 | 118% |
| American Health Advantage Of Idaho | $290 | 119% |
| Selecthealth | $346 - $2,891 | 142% |
| Pacificsource Health Plans | $426 - $3,019 | 175% |
| Moda Health | $552 - $3,116 | 226% |
| Healthcare Management Admin | $666 | 273% |
| Blue Benefit Administrators Of Massachusetts | $696 | 286% |
| Blue Care Network | $696 | 286% |
| Blue Distinction Transplant | $696 | 286% |
| Blue Shield - Ca | $696 | 286% |
| Blue Shield - Id (Regence) | $696 | 286% |
| Blue Shield - Ny Highmark Northeastern | $696 | 286% |
| Blue Shield - Ny Highmark Western | $696 | 286% |
| Blue Shield - Pa (Highmark) | $696 | 286% |
| Blue Shield - Wa (Regence) | $696 | 286% |
| Webtpa | $750 - $2,891 | 308% |
| Ada County Jail Inmate Ins | $964 | 395% |
| Ambetter / Centene | $964 | 395% |
| Amish Mennonite | $964 | 395% |
| Bcccp-Michigan | $964 | 395% |
| Bccp | $964 | 395% |
| Bmc Healthnet | $964 | 395% |
| Breast Grant-Connecticut | $964 | 395% |
| California Health And Wellness | $964 | 395% |
| Cardinal Innovations Lme | $964 | 395% |
| Care Oregon Ohp | $964 | 395% |
| Cencal Health Plan | $964 | 395% |
| Cenpatico | $964 | 395% |
| Centurion Of Idaho | $964 | 395% |
| Chhuny | $964 | 395% |
| Childrens Comm Health Plan | $964 | 395% |
| Childrens Medical Services Title 19 | $964 | 395% |
| Cigna | $964 - $3,019 | 395% |
| Community Benefit Health | $964 | 395% |
| Community Care Behavorial Health | $964 | 395% |
| Community Health Choice | $964 | 395% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $964 | 395% |
| Dean Wi Badgercare | $964 | 395% |
| Delaware First Health | $964 | 395% |
| Delta Dental Nj | $964 | 395% |
| Dph Tb Program | $964 | 395% |
| Dscc | $964 | 395% |
| Eastpointe Lme | $964 | 395% |
| Family Health Network | $964 | 395% |
| Freedom First Healthcare | $964 | 395% |
| Ghc Scw Wi Badgercare | $964 | 395% |
| Harbor Health | $964 | 395% |
| Health Safety Net | $964 | 395% |
| Healthy Blue Ne | $964 | 395% |
| Hennepin Health | $964 | 395% |
| Humana | $964 - $2,827 | 395% |
| Id County Ada | $964 | 395% |
| Id County Canyon | $964 | 395% |
| Id County Cat Fund | $964 | 395% |
| Id County Payette | $964 | 395% |
| Idaho Womens Health Check | $964 | 395% |
| Indiana Breast Cervical Cancer | $964 | 395% |
| Inland Empire Health Plan | $964 | 395% |
| Intercommunity Health Ohp | $964 | 395% |
| Iowa Total Care | $964 | 395% |
| Jai Medical System | $964 | 395% |
| Kern Family Health Plan | $964 | 395% |
| Keystone First | $964 | 395% |
| Keystone First Chip | $964 | 395% |
| La Care Health Plan | $964 | 395% |
| Lakeland Care Inc | $964 | 395% |
| Managed Health Services - Indiana | $964 | 395% |
| Maryland Breast & Cervical Program | $964 | 395% |
| Maryland Healthy Smiles - Scion Dental | $964 | 395% |
| Maryland Physicians Care | $964 | 395% |
| Massachusetts Behavioral Health Partnership | $964 | 395% |
| Mdwise | $964 | 395% |
| Medi-Cal | $964 | 395% |
| Medi-Cal Healthnet | $964 | 395% |
| Medstar Dc Healthy Family | $964 | 395% |
| Medstar Md Health Choice | $964 | 395% |
| Mo Home State Health Plan | $964 | 395% |
| Molina Centennial Care | $964 | 395% |
| Nascentia Health Options | $964 | 395% |
| Nebraska Total Care | $964 | 395% |
| New York Cancer Services Program | $964 | 395% |
| Nextlevel Health | $964 | 395% |
| Oregon Screenwise | $964 | 395% |
| Pace Of Southwest Michigan | $964 | 395% |
| Paramount Advantage | $964 | 395% |
| Parkland Community Health Plan | $964 | 395% |
| Partners Behavioral Lme | $964 | 395% |
| Peach State Healthplan | $964 | 395% |
| Presbyterian Centennial Care | $964 | 395% |
| Prestige Health Choice | $964 | 395% |
| Priority Partners | $964 | 395% |
| Rx 340B Pass Along | $964 | 395% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $964 | 395% |
| Rx Medi-Cal | $964 | 395% |
| Rx Meridian Rx | $964 | 395% |
| Sandhills Center Lme | $964 | 395% |
| Screening For Life | $964 | 395% |
| Sunshine State Health Plan | $964 | 395% |
| Superior Health | $964 | 395% |
| Tenncare | $964 | 395% |
| Texas Children'S Health Plan | $964 | 395% |
| Trillium Community Ohp | $964 | 395% |
| Tufts Health Public Plans | $964 | 395% |
| Vaya Health Lme | $964 | 395% |
| Wellsense Health Plan | $964 | 395% |
| Wi Womens Wellness | $964 | 395% |
| Mountain Health Co-Op | $1,927 | 790% |
| Allegiance | $2,441 | 1001% |
| Correctional Health Partners | $2,505 | 1028% |
| Columbia Health Network | $2,570 | 1054% |
| Healthnet | $2,698 | 1107% |
| Allied National Global Care | $2,891 | 1186% |
| Asrm - Reliance Standard Life Insurance | $2,891 | 1186% |
| Christian Care Ministry | $2,891 | 1186% |
| Dean Health | $2,891 | 1186% |
| Fallon Health | $2,891 | 1186% |
| Family Life Insurance Company | $2,891 | 1186% |
| First Choice Health | $2,891 | 1186% |
| Ghc Scw | $2,891 | 1186% |
| International Benefit Administrators | $2,891 | 1186% |
| Lifetime Benefit Solutions | $2,891 | 1186% |
| Manhattan Life | $2,891 | 1186% |
| Pai | $2,891 | 1186% |
| Pan-American Life | $2,891 | 1186% |
| Paramount Hmo | $2,891 | 1186% |
| Phcs | $2,891 | 1186% |
| Trinity Health Share | $2,891 | 1186% |
| Lifewise | $2,987 | 1225% |
| Priority Health | $3,019 | 1238% |
| Allied Benefit Systems | $3,042 | 1248% |
| Ameriben | $3,042 | 1248% |
| Asr Health Benefits | $3,042 | 1248% |
| Christian Brother Services | $3,042 | 1248% |
| Geha | $3,042 - $3,084 | 1248% |
| Healthez | $3,042 | 1248% |
| Luminare Health (Detroit) | $3,042 | 1248% |
| Rural Carrier Health Benefit Plan | $3,042 | 1248% |
| First Health | $3,051 | 1252% |
| Medi Share | $3,051 | 1252% |
| Providence | $3,051 | 1252% |