CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Johnson City Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $365
Cash Discount Price: $532
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Johnson City Medical Center is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.50x the Medicare baseline. Located in 400 N State of Franklin Rd, Johnson City, TN.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

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: $532 (218%)

Insurance Median: $365 (150%)

Cash: $532 (218% of Medicare)

Ins. Median: $365 (150% 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.

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
Blue Cross Blue Shield	$117 - $700	48%
Amerigroup	$221 - $223	91%
Aetna	$223 - $2,262	91%
Humana	$223	91%
Managed Medicaire	$223	91%
Medicare (plans)	$223	91%
Mountain Empire Pace	$223	91%
Sentara Health	$223 - $1,237	91%
United Mine Workers Of America	$223	91%
UnitedHealthcare	$223 - $3,545	91%
Molina Healthcare	$232 - $423	95%
Cigna	$234 - $542	96%
Devoted Health Plan	$234	96%
Nhc Advantage	$234	96%
Wellcare	$236 - $3,545	97%
Optima Health	$407	167%
Ambetter / Centene	$485	199%
Medcost	$1,241	509%
First Health Coventry	$2,659	1091%
Seven Corners, Inc.	$3,545	1454%

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 $532.
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 Johnson City Medical Center 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.