CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Grossmont Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $4,061
Cash Discount Price: $4,994
vs. Medicare Baseline: 11.39x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Grossmont Hospital is $4,061. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,994. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.39x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$4,994

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,061

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $4,994 (1401%)

Insurance Median: $4,061 (1139%)

Cash: $4,994 (1401% of Medicare)

Ins. Median: $4,061 (1139% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 1139% of the Medicare baseline (a markup of 1039%). 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
Aetna	$421 - $4,661	118%
Health Net	$932 - $4,661	261%
Blue Shield	$1,977 - $4,994	555%
Indian Health Council	$2,031 - $4,061	570%
Medicare (plans)	$2,031	570%
Allianz Global Assistance	$2,264	635%
Blue Cross Blue Shield	$3,196 - $4,661	897%
Community Health Group	$3,762 - $4,494	1055%
UnitedHealthcare	$3,995 - $5,127	1121%
Medi-Cal	$4,061	1139%
Humana	$4,228	1186%
Epic Americas	$4,248	1192%
Kaiser	$4,248	1192%
Molina	$5,460	1532%

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 $4,994.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
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.