CMS Price Transparency Data
CT scan, abdomen and pelvis (with contrast)
Facility: San Antonio Regional Hospital
Billing Code: 74177 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74177
- Insurance Median: $673
- Cash Discount Price: $1,243
- vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at San Antonio Regional Hospital is $673. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.89x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,243
Average discount available for prompt cash payment at this facility.
Insurance Median
$673
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: $1,243 (349%)
Insurance Median: $673 (189%)
Cash: $1,243 (349% of Medicare)
Ins. Median: $673 (189% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal | $404 | 113% |
| UnitedHealthcare | $420 - $1,345 | 118% |
| Kaiser Medi-Cal | $424 | 119% |
| Healthnet Medi-Cal | $426 | 120% |
| Tricare | $440 | 123% |
| Alpha Care Mg Mcal/Hlthy Kids | $445 | 125% |
| Heritage Prov Ntwrk/Regal Mcal | $445 | 125% |
| Blue Shield Mcr Adv | $449 | 126% |
| Caremore Mcr Adv - All Plans | $449 | 126% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $449 | 126% |
| Healthnet Mcr Adv | $449 | 126% |
| Humana | $449 | 126% |
| Iehp Mcr Adv | $449 | 126% |
| Inter Valley Hp Mcr Adv- All Plans | $449 | 126% |
| Kindred Mcr Adv-All Plans | $449 | 126% |
| Molina Mcr Adv | $449 | 126% |
| Scan Health Plan Mcr Adv-All Plans | $449 | 126% |
| Universal Care - All Plans | $449 | 126% |
| Blue Cross Blue Shield | $458 - $10,737 | 128% |
| Molina Medi-Cal | $465 | 130% |
| Zelis Mcr Adv | $471 | 132% |
| Kasiser Mcr Adv | $480 | 135% |
| Pc Inland Valley Scan | $481 | 135% |
| Pc Inland Valley-All Other Plans | $481 | 135% |
| Imperial Health Mcr Adv-All Plans | $494 | 139% |
| Iehp Mcal | $525 | 147% |
| Choicecare Ntwrk-All Plans | $550 | 154% |
| Choice Phycn Ntwrk Op Only | $561 | 157% |
| Molina Exchange-All Other Plans | $583 | 164% |
| Aetna | $606 - $19,755 | 170% |
| Iehp Comm - All Other Plans | $651 | 183% |
| Redlands Employee | $673 | 189% |
| Redlands Hmo-All Other Plans | $700 | 196% |
| Prime Health - All Plans | $785 | 220% |
| Healthnet - All Other Plans | $1,074 | 301% |
| Coventry Ccn/First Hlth - All Plans | $1,200 | 337% |
| Kaiser Comm - All Other Plans | $1,252 | 351% |
| Blue Shield Epn | $1,271 | 357% |
| Ambetter / Centene | $2,730 | 766% |
| Blue Shield Epo Ppo - All Other Plans | $3,244 | 910% |
| Blue Shield Hmo Pos / Calpers Ppo | $3,244 | 910% |
| Epic Health Plan - All Other Plans | $5,926 | 1663% |
| Networks By Design - All Plans | $8,574 | 2406% |
| Multiplan/Phcs - All Plans | $14,224 | 3991% |
| Zelis Comm-All Other Plans | $14,816 | 4157% |
| Foundation Inland Epo-All Other Plans | $15,804 | 4434% |
| Foundation Inland Ppo | $16,792 | 4711% |
| Health Payors - All Plans | $17,780 | 4988% |
| Interplan - All Plans | $17,780 | 4988% |
| Wellcare/Easy Choice-All Plans | $19,360 | 5432% |
| Alpha Care Mg Mcr Adv | $19,755 | 5542% |
| Central Hlth Plan Mcr Adv-All Plans | $19,755 | 5542% |
| Epic Health Plan Mcr Adv | $19,755 | 5542% |
| Prospect Hp-All Plans | $19,755 | 5542% |
| Providence Clevercare Mcr Adv | $19,755 | 5542% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $20,051 | 5626% |
| Clever Care Mcr Adv - All Plans | $20,743 | 5820% |
| La Salle Hp Mcr Adv-All Plans | $20,743 | 5820% |
| Providence Oscar-All Other Plans | $20,743 | 5820% |
| Alpha Care Mg-All Other Plans | $24,694 | 6928% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $36,300 | 10184% |