CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: UPMC Carlisle

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $389
Cash Discount Price: $1,072
vs. Medicare Baseline: 1.60x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at UPMC Carlisle is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,072. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.60x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.

Cash / Self-Pay

$1,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$389

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: $1,072 (440%)

Insurance Median: $389 (160%)

Cash: $1,072 (440% of Medicare)

Ins. Median: $389 (160% 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
Prime Net	$74 - $2,295	30%
Blue Cross Blue Shield	$108 - $1,661	44%
Keystone Health Plan	$108 - $1,661	44%
UnitedHealthcare	$132 - $2,234	54%
Aetna	$211 - $1,485	87%
Amerihealth Caritas	$214	88%
Highmark Wholecare (Prev Gateway)	$214	88%
Upmc Health Plan	$219 - $2,683	90%
Health Partners Plans (Jefferson Health Plan)	$229	94%
Humana	$231	95%
Cigna	$243 - $1,225	100%
Geisinger	$243 - $2,193	100%
Pa Health & Wellness	$250 - $287	103%
Premier Comp Solutions	$280	115%
Upmc Work Partners	$336	138%
Wellspan Population Health	$350 - $2,429	144%
Keystone Autism Services	$370	152%
Multiplan	$457 - $2,581	187%

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 $1,072.
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 UPMC Carlisle 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.