CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Childrens Hospital of Wisconsin Fox Valley

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $1,215
Cash Discount Price: $788
vs. Medicare Baseline: 4.98x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Childrens Hospital of Wisconsin Fox Valley is $1,215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $788. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.98x the Medicare baseline. Located in 130 Second St, Neenah, WI.

Cash / Self-Pay

$788

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,215

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: $788 (323%)

Insurance Median: $1,215 (498%)

Cash: $788 (323% of Medicare)

Ins. Median: $1,215 (498% 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 498% of the Medicare baseline (a markup of 398%). 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
Froedtert Health	$1,003 - $1,218	411%
Medical College Of Wisconsin	$1,003	411%
Network Health Plan	$1,020	418%
UnitedHealthcare	$1,053 - $1,090	432%
Aspirus Health Plan	$1,075	441%
Common Ground Healthcare Cooperative	$1,075 - $1,218	441%
Trilogy Health Solutions	$1,075 - $1,218	441%
Wps Health Plan	$1,089 - $1,289	447%
Advocate Aurora Healthcare	$1,103	452%
Blue Cross Blue Shield	$1,118 - $1,361	459%
Centivo	$1,118	459%
Health Partners	$1,118 - $1,261	459%
Employer Health Care Alliance Cooperative	$1,125	462%
Dean Health Plan	$1,146	470%
Group Health Cooperative Of Eau Claire	$1,146	470%
Oan Llc	$1,146	470%
Security Health Plan	$1,189	488%
Health Payment Systems	$1,212	497%
Praire States	$1,218	500%
Quartz Health Insurance	$1,218	500%
Sheboygan Employer'S Health Network	$1,218	500%
America'S Ppo	$1,246	511%
Aetna	$1,261 - $1,275	517%
Bellin Thedacare	$1,289	529%
Cigna	$1,289	529%
Group Health Cooperative Of South Central Wisconsin	$1,289	529%
Healthsmart	$1,289	529%
Prevea Health Network	$1,289	529%
Multiplan	$1,304 - $1,361	535%
Coventry Health Care	$1,361	558%

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 $788.
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 Childrens Hospital of Wisconsin Fox Valley 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.