CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Intermountain Health Spanish Fork Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $1,588
  • Cash Discount Price: $2,808
  • vs. Medicare Baseline: 6.51x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Intermountain Health Spanish Fork Hospital is $1,588. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,808. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.51x the Medicare baseline. Located in 765 East Market Place Drive, Spanish Fork, UT.
Cash / Self-Pay
$2,808

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,588

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: $2,808 (1152%)
Insurance Median: $1,588 (651%)
Cash: $2,808 (1152% of Medicare)
Ins. Median: $1,588 (651% 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 651% of the Medicare baseline (a markup of 551%). 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
Aetna $82 - $3,183 34%
American Health $82 - $251 34%
Blue Cross Blue Shield $82 - $2,846 34%
Health Partners Of Nevada $82 - $241 34%
Health Plan Of Nevada $82 - $1,123 34%
Healthy U $82 - $241 34%
Humana $82 - $253 34%
Molina $82 - $265 34%
Selecthealth $82 - $1,895 34%
UnitedHealthcare $82 - $3,183 34%
Triwest $232 95%
Donor Connect $243 - $1,011 100%
Intermountain Caregiver Plan $584 - $1,805 240%
Awh Connected $934 - $2,434 383%
Byu Athletics $934 - $2,696 383%
Campbell Scientific $934 - $2,696 383%
Deseret Mutual $934 - $2,153 383%
Emi $934 - $2,022 383%
Emi Health $934 - $2,599 383%
Franklin County $934 - $2,696 383%
Ifit $934 - $2,696 383%
Juniper Systems $934 - $2,696 383%
Lw Miller $934 - $2,696 383%
Pehp $934 - $3,333 383%
Tanner Llc $934 - $2,696 383%
Utah Tech $934 - $2,696 383%
Cigna $2,359 - $3,183 968%
Byu Risk Management $2,621 - $2,734 1075%
Corporation Of The President $2,621 - $2,734 1075%
Wcf Insurance $2,621 - $2,734 1075%
Corvel Corporation $2,696 1106%
Injury Care Of Nevada $2,808 1152%
Managed Care Admin $2,921 1198%
Prodegi Corp Benefit $3,071 1260%
Uofu $3,071 1260%
Springtide $3,108 1275%
Global Excel $3,183 1306%
Medcare International $3,183 1306%
Motivhealth $3,183 1306%
Wise Network $3,183 1306%
Hygeia Corporation $3,370 1382%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 765 East Market Place Drive, Spanish Fork, UT 84660
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals