CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $2,653
Cash Discount Price: $5,378
vs. Medicare Baseline: 10.88x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Cook Childrens Medical Center Prosper is $2,653. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,378. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.88x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$5,378

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,653

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: $5,378 (2206%)

Insurance Median: $2,653 (1088%)

Cash: $5,378 (2206% of Medicare)

Ins. Median: $2,653 (1088% 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 1088% of the Medicare baseline (a markup of 988%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$209 - $6,095	86%
Beacon	$294 - $3,872	121%
El Paso Health First	$294 - $3,872	121%
Health Plan W. Uhrip	$294	121%
Health Plan W/O Uhrip	$294 - $3,872	121%
Tx Children Health	$294 - $3,872	121%
Wellpoint	$309	127%
Blue Cross Blue Shield	$318 - $6,453	130%
Superior Health	$318	130%
Firstcare	$324 - $5,736	133%
United Community	$324 - $2,653	133%
UnitedHealthcare	$3,155 - $6,095	1294%
S&W Health	$6,023	2471%
Cigna	$6,095	2500%
Healthscope	$6,095	2500%
Imagine Health	$6,095	2500%
Humana	$6,238 - $6,310	2559%
Multiplan	$6,238	2559%
First Health	$6,310	2589%
Galaxy Health	$6,453	2647%
Healthsmart	$6,453	2647%
Usamco	$6,597	2706%

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 $5,378.
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 Cook Childrens Medical Center Prosper 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.