CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Pennsylvania Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $3,234
  • Cash Discount Price: $12,439
  • vs. Medicare Baseline: 13.27x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Pennsylvania Hospital is $3,234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12,439. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.27x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$12,439

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,234

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: $12,439 (5103%)
Insurance Median: $3,234 (1327%)
Cash: $12,439 (5103% of Medicare)
Ins. Median: $3,234 (1327% 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 1327% of the Medicare baseline (a markup of 1227%). 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
Gateway Health Plan $101 - $309 41%
Medicaid / KanCare $101 - $12,439 41%
Keystone Mercy Health Plan $129 53%
Upmc $151 - $12,439 62%
Pa Medical Assistance $168 69%
UnitedHealthcare $199 - $12,439 82%
Health Partners $243 - $12,439 100%
Blue Cross Blue Shield $250 - $12,439 103%
Medicare (plans) $250 - $255 103%
Philadelphia Va Medical Center $250 103%
Tricare $251 103%
Ibc $255 105%
Cigna $257 - $298 105%
Geisinger Health Plan $257 - $791 105%
Humana $257 - $9,951 105%
Pa Health And Wellness $262 - $412 107%
Penn Life (Living Independently For Elders) $262 107%
Aetna $265 - $12,439 109%
Clover Health Plan $270 111%
Keystone First $277 114%
Us Family Health Plan $288 118%
Keystone Hmo Proactive $296 121%
Ibc Commercial Hpn $305 125%
Elap $354 145%
Claims Watcher $399 - $449 164%
Oscar Health Plan $424 174%
Centivo $449 184%
Elap Services $464 190%
Highmark $525 215%
Penn Global Medicine $661 271%
Horizon Nj Health $2,102 - $2,187 862%
Pgm - Regie De L'Assurance Maladie Quebec $2,861 1174%
Preferred Health Care Eliance $3,234 1327%
Pgm - Kuwait Defense $4,354 - $5,598 1786%
Devon $4,727 - $5,598 1939%
Qualcare $4,727 1939%
Coventry $4,976 - $6,344 2041%
Pgm - Chop $4,976 2041%
Wissahickon Hospice $4,976 2041%
Healthamerica/Coventry $5,598 - $6,095 2296%
Olympus $6,045 2480%
First Health Global $6,220 2552%
Urn-Cancer Resource Services $6,220 2552%
Health Net $7,463 3061%
Pgm - Royal Embassy Of Saudi Arabia $7,463 3061%
Pgm - Embassy Of Qatar $8,085 3317%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $8,085 3317%
Pgm - Embassy Of The United Emirates/Ipc $8,707 3572%
Devon Health Services Inc $9,951 4082%
Health America/Ccn $9,951 4082%
Intergroup $9,951 4082%
Pgm - Kuwait Health Division $9,951 4082%
Pgm - Kuwait Oil $9,951 4082%
Preferred Care $9,951 4082%
Commercial Other $12,439 5103%
Community Behavioral Health $12,439 5103%
International Pfs $12,439 5103%
Quest Behavioral Health $12,439 5103%
United Behavioral Health $12,439 5103%
Workers Compensation $12,439 5103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals