CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Stonesprings Hospital Center

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,539
Cash Discount Price: $7,772
vs. Medicare Baseline: 6.31x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Stonesprings Hospital Center is $1,539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,772. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.31x the Medicare baseline. Located in 24440 Stone Springs Boulevard, Dulles, VA.

Cash / Self-Pay

$7,772

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,539

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: $7,772 (3188%)

Insurance Median: $1,539 (631%)

Cash: $7,772 (3188% of Medicare)

Ins. Median: $1,539 (631% 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 631% of the Medicare baseline (a markup of 531%). 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
Blue Cross Blue Shield	$307 - $782	126%
United	$518 - $3,498	212%
Lifeworks	$1,477	606%
Cigna	$1,539 - $2,619	631%
Aetna	$1,819	746%
Carefirst	$3,206	1315%
Greenvbrier Sporting Club	$4,663	1913%
Virginia Health Network	$5,518	2264%
Corvel	$5,596	2296%
Three Rivers Provider Network	$6,606	2710%

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 $7,772.
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 Stonesprings Hospital Center 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.