CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $236
  • Cash Discount Price: $1,814
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Oakleaf Surgical Hospital is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,814. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$1,814

Average discount available for prompt cash payment at this facility.

Insurance Median
$236

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: $1,814 (744%)
Insurance Median: $236 (97%)
Cash: $1,814 (744% of Medicare)
Ins. Median: $236 (97% 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.

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
Blue Cross Blue Shield $236 - $1,748 97%
Dean Health Plan $236 97%
Group Health Cooperative Of Eau Claire $236 97%
Healthpartners $236 97%
Humana $236 97%
Medica $236 97%
Quartz Health Solutions $236 97%
Security Health Plan Of Wi $236 - $876 97%
Ucare Wi $236 97%
UnitedHealthcare $236 97%
Alliance $1,182 485%

Consumer Guidance & Cost Commentary

For a CT scan of the abdomen and pelvis (no contrast) at Oakleaf Surgical Hospital in Altoona, WI, the facility's cash median rate of $1,814 is significantly lower than the gross charge of $2,015, offering a potential savings of $201 for self-pay patients. This cash price is also notably lower than the Medicare benchmark of $243.77, which serves as the federal government's objective baseline for the true cost of delivery. While many commercial payers such as Blue Cross Blue Shield and Security Health Plan Of Wi have negotiated rates ranging from $236 to $1,748, the cash option remains the most affordable entry point, particularly for those with high-deductible plans where the insurance negotiated rate might exceed the cash price.

Patients should be aware that hospitals often offer prompt-pay discounts of 20% to 50% for upfront payments, which can further reduce the $1,814 cash median to a lower out-of-pocket amount. It is crucial to request self-pay classification and prompt-pay rates before check-in and to sign a waiver of insurance submission to avoid automatic claims processing that would void these cash agreements. Additionally, under the No Surprises Act, patients are generally protected from balance billing for out-of-network services at in-network facilities, though they should always request a full itemized CPT-coded bill to verify that no unbundled codes or services not rendered have inflated the final charge.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals