CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: St Anthony Community Hospital

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $923
  • Cash Discount Price: $4,342
  • vs. Medicare Baseline: 3.79x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at St Anthony Community Hospital is $923. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,342. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.79x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$4,342

Average discount available for prompt cash payment at this facility.

Insurance Median
$923

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: $4,342 (1781%)
Insurance Median: $923 (379%)
Cash: $4,342 (1781% of Medicare)
Ins. Median: $923 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Emblem $253 - $482 104%
Medicare (plans) $296 - $317 121%
Mvp Gold (McR) $296 121%
Hamaspik (McR) $296 121%
Emblem Select Care (Exchange) $297 122%
Tricare $298 122%
Affinity By Molina McR $311 128%
Aetna $319 - $355 131%
Emblem Ghi/Hip PPO $349 143%
Cigna $416 171%
Mvp Exchange $440 180%
Mvp Hmo/Ppo $855 351%
Blue Cross Blue Shield $915 - $5,649 375%
Geisinger Health Commercial/Exchange $978 401%
Self-Pay $1,012 415%
Self-Pay - Cc 30% $1,303 535%
Oxford Commercial $1,931 792%
Self-Pay - Cc 50% $2,171 891%
Cdphp $2,171 891%
Oxford Exchange $2,532 1039%
UnitedHealthcare $2,532 - $2,979 1039%
PHCS $3,256 1336%
Multiplan $3,256 1336%
Emblem Ghi/Hip Hmo/Epo/Pos $3,474 1425%
First Health $3,691 1514%
Magnacare Preferred $3,908 1603%
Mvp $41,347 - $48,731 16961%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals