Cost analysis for CPT 74178 — Ct scan of abdomen and pelvis before and after contrast
Average Medicare Payment
$126.60
2023 data
Total Payments (2023)
$61.8M
Services (2023)
432.5K
Price Change (2014–2023)
-5.7%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $134.21 | $81.4M | 566.6K | — |
| 2015 | $128.00 | $73.8M | 538.4K | -4.6% |
| 2016 | $126.31 | $71.8M | 521.3K | -1.3% |
| 2017 | $125.67 | $70.4M | 509.8K | -0.5% |
| 2018 | $125.20 | $70.0M | 506.0K | -0.4% |
| 2019 | $129.33 | $71.7M | 502.0K | +3.3% |
| 2020 | $134.30 | $63.9M | 425.2K | +3.8% |
| 2021 | $134.41 | $68.9M | 452.7K | +0.1% |
| 2022 | $130.09 | $62.0M | 418.3K | -3.2% |
| 2023 | $126.60 | $61.8M | 432.5K | -2.7% |
The most expensive state pays 3.9x more than the cheapest for this procedure. GU averages $285.02 vs WV at $72.83.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| GU | $285.02 | $111.2K | 390 | 4 |
| NJ | $208.62 | $2.1M | 10.0K | 281 |
| MD | $207.79 | $2.1M | 10.0K | 244 |
| PR | $205.65 | $62.7K | 305 | 15 |
| AZ | $195.52 | $1.9M | 9.5K | 211 |
| CA | $190.72 | $9.3M | 48.9K | 1.1K |
| FL | $188.35 | $6.9M | 36.9K | 834 |
| NY | $184.92 | $5.7M | 30.8K | 690 |
| NV | $183.04 | $544.7K | 3.0K | 87 |
| HI | $178.23 | $129.2K | 725 | 29 |
| AK | $176.84 | $107.9K | 610 | 19 |
| DC | $176.03 | $217.4K | 1.2K | 35 |
| RI | $163.46 | $285.6K | 1.7K | 50 |
| WY | $158.19 | $119.3K | 754 | 21 |
| CT | $154.49 | $521.1K | 3.4K | 114 |
| VA | $142.25 | $1.6M | 11.4K | 278 |
| DE | $137.50 | $216.6K | 1.6K | 30 |
| TX | $136.31 | $5.3M | 39.0K | 908 |
| MN | $136.16 | $1.4M | 10.5K | 344 |
| WA | $129.47 | $714.1K | 5.5K | 193 |
| TN | $128.85 | $1.3M | 10.3K | 302 |
| CO | $127.63 | $685.4K | 5.4K | 179 |
| NM | $123.63 | $230.7K | 1.9K | 43 |
| UT | $121.75 | $167.8K | 1.4K | 59 |
| AL | $121.39 | $919.7K | 7.6K | 224 |
| KS | $118.06 | $585.4K | 5.0K | 133 |
| IL | $117.46 | $1.9M | 15.9K | 494 |
| GA | $116.20 | $1.2M | 10.4K | 284 |
| SD | $116.11 | $156.3K | 1.3K | 51 |
| IN | $115.63 | $866.0K | 7.5K | 210 |
| AR | $115.43 | $1.4M | 11.9K | 167 |
| NC | $112.39 | $1.7M | 14.7K | 398 |
| SC | $110.45 | $948.1K | 8.6K | 206 |
| MS | $108.77 | $762.7K | 7.0K | 147 |
| IA | $105.84 | $345.8K | 3.3K | 99 |
| MA | $105.70 | $961.1K | 9.1K | 296 |
| NE | $105.51 | $501.8K | 4.8K | 122 |
| LA | $104.28 | $787.5K | 7.6K | 195 |
| MO | $104.26 | $959.5K | 9.2K | 292 |
| OR | $103.40 | $461.8K | 4.5K | 128 |
| NH | $102.74 | $213.3K | 2.1K | 77 |
| PA | $102.54 | $1.6M | 15.4K | 458 |
| MT | $98.11 | $115.7K | 1.2K | 47 |
| MI | $96.82 | $788.2K | 8.1K | 285 |
| WI | $96.55 | $453.6K | 4.7K | 190 |
| VT | $95.97 | $48.7K | 507 | 21 |
| OH | $94.45 | $857.4K | 9.1K | 290 |
| OK | $93.93 | $541.6K | 5.8K | 180 |
| ID | $92.34 | $161.4K | 1.7K | 64 |
| KY | $91.26 | $561.5K | 6.2K | 143 |
| ME | $87.27 | $73.0K | 836 | 42 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Bayani Evangelista | Diagnostic Radiology | CA | $316.3K | 1.3K | $251.39 |
| Gateway Diagnostic Imaging Llc | Independent Diagnostic Testing Facility (IDTF) | TX | $215.3K | 835 | $257.86 |
| Varghese Cherian | Diagnostic Radiology | NY | $211.2K | 622 | $339.50 |
| Chad Engel | Diagnostic Radiology | FL | $158.6K | 877 | $180.84 |
| Ronald Wachsberg | Diagnostic Radiology | NJ | $153.9K | 881 | $174.66 |
| Carolinas Imaging Services Llc | Independent Diagnostic Testing Facility (IDTF) | NC | $150.1K | 584 | $257.01 |
| Vaiman Tsang | Diagnostic Radiology | NY | $129.2K | 386 | $334.61 |
| Orange County Diagnostic Radiology, Inc. | Independent Diagnostic Testing Facility (IDTF) | CA | $127.0K | 391 | $324.89 |
| Eric Vensel | Diagnostic Radiology | FL | $119.2K | 431 | $276.51 |
| Stanley Litvak | Diagnostic Radiology | FL | $115.5K | 427 | $270.53 |
| Broadway Imaging Medical Center | Independent Diagnostic Testing Facility (IDTF) | CA | $114.1K | 354 | $322.23 |
| Dmitriy Shnayderman | Diagnostic Radiology | CA | $112.7K | 391 | $288.23 |
| Bowes Imaging Center Llc. | Independent Diagnostic Testing Facility (IDTF) | FL | $105.4K | 398 | $264.72 |
| Navid Moradshahi | Interventional Radiology | CA | $103.8K | 349 | $297.32 |
| Pareen Mehta | Diagnostic Radiology | CA | $93.1K | 316 | $294.64 |
| Grygori Gerasymchuk | Diagnostic Radiology | FL | $92.2K | 367 | $251.29 |
| Eric Schaefer | Hematology-Oncology | AR | $86.9K | 484 | $179.54 |
| Daniel Zurcher | Diagnostic Radiology | NV | $86.9K | 315 | $275.77 |
| Marshall Bein | Diagnostic Radiology | CA | $85.5K | 274 | $312.11 |
| Gregory Oakhill | Hematology-Oncology | AR | $85.1K | 477 | $178.45 |
The data suggests significant pricing inconsistencies for CPT 74178. With a 3.9x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 5.7% since 2014, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.