CT scan, abdomen and pelvis (no contrast)
Facility: Susan B Allen Memorial Hospital
Billing Code: 74176 (CPT)
- CPT Billing Code: 74176
- Insurance Median: $635
- Cash Discount Price: $741
- vs. Medicare Baseline: 2.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 260% of the Medicare baseline (a markup of 160%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 144% |
| Providrs Care | $919 | 377% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis without contrast at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $741.00, which is lower than the facility's negotiated rates of $635.00 and $919.00 for UnitedHealthcare and Providrs Care, respectively. While commercial insurance contracts often set a ceiling to protect members, these negotiated amounts can exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans. To secure the lowest possible rate, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as hospitals frequently offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles.
When evaluating the cost against the broader market, it is important to compare rates to the Medicare benchmark rather than the hospital's inflated chargemaster list. For this procedure, the Medicare amount is $243.77, and the facility's cash rate of $741.00 represents a markup of 2.6 times the Medicare rate. This comparison helps reveal the true cost baseline, as commercial rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150%. By focusing on the Medicare rate as the objective standard, patients can better understand the facility's pricing structure and avoid being misled by large percentage discounts calculated off the gross charge.