CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: St Mary Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $309
  • Cash Discount Price: $2,896
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at St Mary Medical Center is $309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,896. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.27x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$2,896

Average discount available for prompt cash payment at this facility.

Insurance Median
$309

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: $2,896 (1188%)
Insurance Median: $309 (127%)
Cash: $2,896 (1188% of Medicare)
Ins. Median: $309 (127% 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.

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 $116 - $463 48%
Aetna $147 - $3,966 60%
UnitedHealthcare $166 - $2,157 68%
Keystone First $243 - $463 100%
Keystone First Chip $243 - $463 100%
Blue Cross Blue Shield $257 105%
Cigna $260 - $1,701 107%
Align Senior Care $262 107%
Medicare (plans) $264 - $463 108%
Health America Advantra $309 127%
Ambetter / Centene $459 188%
Oscar $463 190%
Prime Healthcare $463 190%
Jefferson Health Plan Commercial $468 192%
Pace-Trinity Health $490 201%
Homestead Health Plans Woods Center $502 206%
Group Pension Administrators $579 238%
Reedman Toll $579 238%
Blue Shield - Pa (Highmark) $696 286%
Upmc Health Plan $1,701 698%
Webtpa $1,701 698%
Geha $1,818 746%
Meritain $3,966 1627%
Multiplan $4,010 1645%
Prime Health Services $4,010 1645%
Galaxy Health Network $4,233 1736%
Three Rivers Provider Network $4,233 1736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals