CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Prisma Health Tuomey Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $525
  • Cash Discount Price: $2,937
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Prisma Health Tuomey Hospital is $525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,937. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.15x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$2,937

Average discount available for prompt cash payment at this facility.

Insurance Median
$525

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: $2,937 (1205%)
Insurance Median: $525 (215%)
Cash: $2,937 (1205% of Medicare)
Ins. Median: $525 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Blue Cross Blue Shield $223 - $2,098 91%
Cigna $223 - $2,258 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $223 91%
Humana $223 - $3,389 91%
Medicare (plans) $223 - $234 91%
Triwest Healthcare Alliance Vcp [902] $223 91%
Va Community Care Network-Vaccn [903] $223 91%
Tricare $226 93%
UnitedHealthcare $231 - $696 95%
Aetna $234 - $3,570 96%
Healthy Conn Prime-First Choice Vip Care [5300] $234 96%
Healthy Conn Prime-Molina Healthcare [5330] $234 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $234 96%
Medicaid / KanCare $296 - $696 121%
Workers Comp [600] $312 128%
Ambetter / Centene $410 168%
Bluechoice [810] $511 - $2,098 210%
Golden Rule Insurance Company [2991] $525 215%
Oxford Health Plans [2992] $525 215%
Zzumr-Salt Lake City Ut [3169] $525 215%
Scdc-Sc Dept Of Corrections [7232] $534 219%
Prisma Health Seniorcare Pace - Midlands [5400] $1,048 430%
Prisma Health Seniorcare Pace-Upstate [5200] $1,048 430%
Bob Jones Univ-Pai [821] $1,536 630%
Promise Health Plan Contracted [2401] $1,582 - $1,875 649%
Orangeburg Senior Helping Center Pace [5401] $1,808 742%
Planned Administrators [820] $2,098 861%
Meritain Health Contracted [2200] $2,892 - $3,570 1186%
Preferred Administrators Contracted [2839] $3,163 1298%
Medcost [2940] $3,344 - $3,751 1372%
Atlantic Packaging Contracted [4833] $3,389 1390%
Aps Healthcare System [2981] $3,615 1483%
Multiplan/Phcs Contracted [2950] $4,022 1650%
Vsp Vision Care [2986] $4,067 1668%
First Health Contracted [2952] $4,203 1724%
Furman Int/Allen University Student [2951] $4,203 1724%
Quiktrip-First Health [3067] $4,203 1724%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals