CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $872
  • Cash Discount Price: $243
  • vs. Medicare Baseline: 3.58x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Wellspan Ephrata Community Hospital is $872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.58x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.
Cash / Self-Pay
$243

Average discount available for prompt cash payment at this facility.

Insurance Median
$872

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: $243 (100%)
Insurance Median: $872 (358%)
Cash: $243 (100% of Medicare)
Ins. Median: $872 (358% 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 358% of the Medicare baseline (a markup of 258%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $126 - $409 52%
Wellspan_Capital_Blue_Cross $196 80%
Blue_Cross $230 - $1,495 94%
Medicare (plans) $236 - $409 97%
Aetna $240 - $957 98%
Highmark $362 - $1,071 149%
First_Health_Network $1,052 432%
Cigna $1,254 - $1,482 514%
United_Healthcare $1,342 551%
Geisinger $1,509 619%
Independence_Blue_Cross $1,509 619%
Tower Health $1,509 - $1,591 619%
Upmc $1,509 - $1,858 619%
Phc $1,625 - $1,649 667%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 169 Martin Avenue, Ephrata, PA 17522
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals