CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: UPMC Altoona

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,974
Cash Discount Price: $2,369
vs. Medicare Baseline: 8.10x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at UPMC Altoona is $1,974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,369. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.10x the Medicare baseline. Located in 620 Howard Avenue, Altoona, PA.

Cash / Self-Pay

$2,369

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,974

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: $2,369 (972%)

Insurance Median: $1,974 (810%)

Cash: $2,369 (972% of Medicare)

Ins. Median: $1,974 (810% 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 810% of the Medicare baseline (a markup of 710%). 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	$101 - $2,092	41%
UnitedHealthcare	$106 - $2,024	43%
Upmc Health Plan	$111 - $2,923	46%
Geisinger	$140 - $2,171	57%
Highmark Wholecare (Prev Gateway)	$150 - $1,974	62%
Health Partners Plans (Jefferson Health Plan)	$152	62%
Amerihealth Caritas	$158	65%
Pa Health & Wellness	$172	71%
Upmc Work Partners	$193	79%
Blue Cross Blue Shield	$474	194%
Cigna	$1,974	810%
Preferred Healthcare System	$1,974	810%
Private Health Care Systems	$3,158	1295%

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 $2,369.
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 Altoona 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.