CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Primary Children's Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $1,315
  • Cash Discount Price: $1,390
  • vs. Medicare Baseline: 5.39x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Primary Children's Hospital is $1,315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,390. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.39x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,315

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: $1,390 (570%)
Insurance Median: $1,315 (539%)
Cash: $1,390 (570% of Medicare)
Ins. Median: $1,315 (539% 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 539% of the Medicare baseline (a markup of 439%). 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
American Health $82 - $1,056 34%
Health Plan Of Nevada $82 - $118 34%
Healthy U $82 - $139 34%
Molina $82 - $1,556 34%
Selecthealth $82 - $1,556 34%
Southwest Behavioral Health $82 - $223 34%
UnitedHealthcare $82 - $1,556 34%
Tricare $232 95%
Triwest $232 95%
Donor Connect $667 - $737 274%
Aetna $1,315 - $1,575 539%
Awh Connected $1,315 - $1,575 539%
Byu Athletics $1,315 - $1,556 539%
Campbell Scientific $1,315 - $1,556 539%
Cigna $1,315 - $1,556 539%
Deseret Mutual $1,315 - $1,556 539%
Emi $1,315 - $1,556 539%
Emi Health $1,315 - $1,556 539%
First Choice $1,315 - $1,556 539%
First Choice Of The Midwest $1,315 - $1,556 539%
Franklin County $1,315 - $1,556 539%
Global Excel $1,315 - $1,556 539%
Health Utah $1,315 - $1,556 539%
Humana $1,315 - $1,556 539%
Hygeia Corporation $1,315 - $1,556 539%
Ifit $1,315 - $1,556 539%
Juniper Systems $1,315 - $1,556 539%
Lw Miller $1,315 - $1,556 539%
Managed Care Admin $1,315 - $1,556 539%
Medcare International $1,315 - $1,556 539%
Motivhealth $1,315 - $1,556 539%
Pehp $1,315 - $1,556 539%
Prodegi Corp Benefit $1,315 - $1,556 539%
Tanner Llc $1,315 - $1,556 539%
Uofu $1,315 - $1,556 539%
Utah Tech $1,315 - $1,556 539%
Wise Network $1,315 - $1,556 539%
First Health $1,334 - $1,575 547%
Blue Cross Blue Shield $1,353 - $1,593 555%
Springtide $1,353 - $1,593 555%
Utah Behavioral Health Network $1,501 616%
Altius Mhnet Behavioral Health $1,630 669%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens