CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Scripps Mercy Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $713
Cash Discount Price: $2,250
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Scripps Mercy Hospital is $713. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,250. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.00x the Medicare baseline. Located in 4077 5Th Ave, San Diego, CA.

Cash / Self-Pay

$2,250

Average discount available for prompt cash payment at this facility.

Insurance Median

$713

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: $2,250 (631%)

Insurance Median: $713 (200%)

Cash: $2,250 (631% of Medicare)

Ins. Median: $713 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Mpmg Mcr Adv [836]	$202	57%
Mpmg [800]	$202	57%
Ocn Mcr Adv [890]	$202	57%
UnitedHealthcare	$202 - $1,710	57%
Cigna	$207 - $540	58%
Sharp Comm Med Grp [812]	$207 - $1,818	58%
Sharp Rees Stealy Med Grp [811]	$207 - $1,818	58%
Ucsd [807]	$207 - $1,818	58%
Aetna	$258 - $1,818	72%
Astiva Mcr Adv [464]	$449	126%
Bc Mcr Adv [830]	$449	126%
Blue Cross Blue Shield	$449 - $1,710	126%
Bs Mcr Adv [829]	$449	126%
Central Health Mcr Adv [441]	$449	126%
Clever Care Mcr Adv [465]	$449	126%
D-Snp Mcr Adv [889]	$449	126%
Dsnp/Csnp - Generic [458]	$449	126%
Family Health Centers Pace Mcr Adv Hmo [556]	$449	126%
Family Health Centers Pace Medi-Cal [555]	$449	126%
Gary And Mary West Pace Medi-Cal Hmo [557]	$449	126%
Gpmg/Altura - Mcr Adv [888]	$449	126%
Hn Mcr Adv [832]	$449	126%
Humana	$449	126%
Integrated Health Partners - Mcr Adv [895]	$449	126%
Kaiser Northern Ca Region Mcr Adv [386]	$449	126%
La Care Mcr Adv Hmo [612]	$449	126%
Medicare (plans)	$449	126%
San Diego Pace Medi-Cal [553]	$449	126%
Scan Mcr Adv [835]	$449	126%
Scan [500]	$449	126%
Scan [818]	$449	126%
Sharp Comm Med Grp Mcr Adv [840]	$449	126%
Sharp Health Plan Mcr Adv [531]	$449	126%
Sharp Health Plan Mcr Adv [897]	$449	126%
Sharp Rees Stealy Med Grp Mcr Adv [841]	$449	126%
St Paul'S Pace Medi-Cal [551]	$449	126%
Ucsd Mcr Adv [873]	$449	126%
Uh Mcr Adv [831]	$449	126%
Uh Palomar Health Mcr Adv [885]	$449	126%
Alignment Health Plan [443]	$462	130%
Mc Alignment [917]	$540	152%
Mc Blue Shield Promise Health Plan [914]	$540	152%
Mc Blue Shield [902]	$540	152%
Mc Health Net [904]	$540	152%
Mc Scan [905]	$540	152%
Mc United [906]	$540	152%
Health Net [340]	$713 - $1,602	200%
Radys Cpmg [803]	$720	202%
Prime Healthcare [614]	$763	214%
Prospect Med Group [893]	$785	220%
Blue Shield [230]	$1,395 - $1,512	391%
Bs [816]	$1,458 - $1,512	409%
Imperial County Phys Med Group [855]	$1,458 - $1,557	409%
Bc [814]	$1,557	437%
Integrated Health Partners [894]	$1,557	437%
Perlman Med Group [899]	$1,557	437%
Hn [815]	$1,602	449%
Centivo [581]	$1,620	455%
Uh [819]	$1,710	480%
Palomar Health [892]	$1,818	510%
Veba Med Grp [813]	$1,818	510%
Kaiser Northern Ca Region Hmo/Ppo [384]	$3,366 - $3,384	944%
Kaiser [380]	$3,366 - $3,384	944%
Kaiser [383]	$3,366 - $3,384	944%
Rady Children'S Hospital [825]	$3,690	1035%
Multi Plan Network [470]	$6,390	1793%
First Health Network [330]	$6,750	1894%
Pnoa [615]	$6,750	1894%
Choice Care Network [270]	$7,200	2020%
Healthsmart [350]	$7,200	2020%

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 $2,250.
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 Scripps Mercy 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.