CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Black River Memorial Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,706
Cash Discount Price: $2,719
vs. Medicare Baseline: 7.00x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Black River Memorial Hospital is $1,706. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,719. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.00x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$2,719

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,706

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: $2,719 (1115%)

Insurance Median: $1,706 (700%)

Cash: $2,719 (1115% of Medicare)

Ins. Median: $1,706 (700% 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 700% of the Medicare baseline (a markup of 600%). 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	$34 - $1,587	14%
My Choice Wisconsin, Inc.	$34 - $1,587	14%
Quartz Health Solutions, Inc	$34 - $2,832	14%
Security Health Plan	$34 - $2,907	14%
The Alliance	$34 - $2,988	14%
UnitedHealthcare	$34 - $2,935	14%
Group Health Cooperative Of Eau Claire	$55 - $3,019	23%
Humana	$77 - $2,894	32%
Multiplan	$101 - $3,081	41%
Corvel	$1,073 - $1,898	440%
Triology Health Solutions	$1,583 - $2,956	649%
Medica	$1,643 - $2,907	674%
Association Benefits Solution	$1,671 - $2,956	685%
Family Health Center Of Marshfield	$1,671 - $2,956	685%
First Health Group Corporation	$1,671 - $2,956	685%
Provider Network Of America	$1,671 - $2,956	685%
Cigna	$1,706 - $3,019	700%
Cofinity	$1,706 - $3,019	700%
Coventry Health Care	$1,706 - $3,019	700%
Custom Benefit Administrators	$1,706 - $3,019	700%
Healthpartners, Inc.	$1,706 - $3,019	700%
Wisconsin Physicians Service Insurance Corp	$1,706 - $3,019	700%
Chorus	$1,724 - $3,050	707%

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 $2,719.
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 Black River Memorial Hospital 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.