CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Freestone Medical Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $1,568
  • Cash Discount Price: $3,929
  • vs. Medicare Baseline: 6.43x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Freestone Medical Center is $1,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,929. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.43x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$3,929

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,568

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: $3,929 (1612%)
Insurance Median: $1,568 (643%)
Cash: $3,929 (1612% of Medicare)
Ins. Median: $1,568 (643% 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 643% of the Medicare baseline (a markup of 543%). 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 $164 - $4,000 67%
Gilsbar $216 - $5,614 89%
Mcaid $294 - $1,179 121%
Misc Mcaid Hmo $294 - $1,684 121%
Superior Health Chip $294 - $1,179 121%
Tx Childrens Mcaid $294 - $1,179 121%
UnitedHealthcare $294 - $1,684 121%
Amerigroup $350 - $1,684 144%
Medicaid / KanCare $350 - $2,593 144%
Rightcare S&W Mcaid $350 - $1,684 144%
Superior Health Mcd $350 - $2,593 144%
Aarp $506 208%
Apwu $506 208%
Fringe Benefits $506 208%
Geha $506 208%
Uhcss $506 208%
Aetna $1,302 - $4,491 534%
Cigna $3,368 1382%
Misc Multiplan $3,929 1612%
Misc Multiplan Auto $3,929 1612%
Misc Multiplan Workcomp $3,929 1612%
Self Pay Gt 083123 $3,929 1612%
Self Pay Lt 090123 $3,929 1612%
Aflac $5,614 2303%
Bankers Life $5,614 2303%
Fairview Nursing Home $5,614 2303%
Humana $5,614 2303%
Icare $5,614 2303%
Inmate Freestone Co $5,614 2303%
Misc Hospice $5,614 2303%
Miscellaneous $5,614 2303%
Miscellaneous Auto $5,614 2303%
Mutual Of Omaha $5,614 2303%
North American Med Empl $5,614 2303%
Standard Life Insurance $5,614 2303%
Tml $5,614 2303%
Zelis Healthcare $5,614 2303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals