CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: St Josephs Community Hospital West Bend

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $2,776
  • Cash Discount Price: $2,424
  • vs. Medicare Baseline: 11.39x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at St Josephs Community Hospital West Bend is $2,776. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,424. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.39x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$2,424

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,776

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: $2,424 (994%)
Insurance Median: $2,776 (1139%)
Cash: $2,424 (994% of Medicare)
Ins. Median: $2,776 (1139% 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 1139% of the Medicare baseline (a markup of 1039%). 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
Allwell $235 96%
Blue Cross Blue Shield $235 - $3,747 96%
Community Care $235 96%
Health Partners $235 - $2,865 96%
Humana $235 96%
Icare $235 96%
Molina $235 96%
Network Health Plan $235 - $1,033 96%
Security Health Plan Secure Savers $235 96%
UnitedHealthcare $235 - $1,565 96%
Aetna $239 - $3,086 98%
Care Wisconsin $242 99%
Centivo $1,322 - $1,455 542%
Sheboygan Employers Health Network $1,791 735%
Froedtert South $1,851 759%
Chorus Community Health Plan $1,895 777%
Common Ground $2,645 1085%
Health Payment Systems $2,776 - $3,563 1139%
Wisconsin Physician Services $3,526 1446%
Trilogy $3,615 1483%
Americas Choice $3,835 1573%
Healtheos $3,835 1573%
Multiplan/Private Healthcare Systems $3,835 1573%
First Health Network $3,879 1591%
Hfn $3,967 1627%
Ibsi Passport $3,967 1627%
Cigna $4,188 1718%
Healthsmart $4,188 1718%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals