CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Ascension Seton Edgar B Davis

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $294
Cash Discount Price: $3,060
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Ascension Seton Edgar B Davis is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,060. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.21x the Medicare baseline. Located in 130 Hays Street, Luling, TX.

Cash / Self-Pay

$3,060

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $3,060 (1255%)

Insurance Median: $294 (121%)

Cash: $3,060 (1255% of Medicare)

Ins. Median: $294 (121% 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
Champva	$118 - $194	48%
Blue Cross Blue Shield	$123 - $1,042	50%
Dell Star	$123 - $290	50%
UnitedHealthcare	$123 - $290	50%
Wellpoint Star	$123 - $290	50%
Wellpoint Star Plus	$123 - $294	50%
Tricare	$185	76%
Ambetter / Centene	$190	78%
Dell Chip/Chip Perinate	$190 - $294	78%
Wellpoint Chip/Chip Perinate	$190 - $294	78%
Wellpoint Star Kids	$190 - $294	78%
Humana	$200	82%
Seton Performance Plus	$625	256%
Aetna	$780 - $1,345	320%
Covenant Health	$1,093	448%
Cigna	$1,610	660%
Superior Star	$2,765 - $4,035	1134%
Superior Star Foster	$2,765 - $4,035	1134%
Superior Star Kids	$2,765 - $4,035	1134%
Superior Star Plus	$2,765 - $4,035	1134%
Superior Chip/Chip Perinate	$3,110 - $4,540	1276%

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 $3,060.
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 Ascension Seton Edgar B Davis 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.