CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Adventist Health Ukiah Valley

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $481
  • Cash Discount Price: $781
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Adventist Health Ukiah Valley is $481. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $781. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.35x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.
Cash / Self-Pay
$781

Average discount available for prompt cash payment at this facility.

Insurance Median
$481

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: $781 (219%)
Insurance Median: $481 (135%)
Cash: $781 (219% of Medicare)
Ins. Median: $481 (135% 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

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
Cigna $48 - $5,830 13%
Blue Shield Mcr Adv $85 - $481 24%
Kaiser Mcr Adv $85 - $481 24%
Tricare $85 - $481 24%
Ah Employee Health Plan - All Plans $94 - $865 26%
UnitedHealthcare $114 - $6,248 32%
Healthnet-All Plans $124 - $4,276 35%
Western Growers-All Plans $126 - $3,140 35%
Blue Shield Epn-All Other Plans $157 - $1,756 44%
Blue Shield Non-Epn $166 - $1,802 47%
Mendocino Lcc District-All Plans $220 - $3,500 62%
Aetna $230 - $1,504 65%
Kaiser-All Other Plans $271 - $5,980 76%
Kaiser Medi-Cal $282 - $404 79%
Medi-Cal $282 - $404 79%
Three Rivers-All Plans $305 - $6,728 86%
Blue Cross Blue Shield $1,088 - $1,451 305%
Foundation For Medical Care-All Plans $5,606 1573%
Networks By Design-All Plans $5,980 1678%
Phcs Multiplan-All Plans $5,980 1678%
Interplan-All Plans $6,130 1720%
Beech Street-All Plans $6,354 1783%
Choice Care-All Plans $6,354 1783%
Health Mgmt Network-All Plans $6,354 1783%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 Hospital Drive, Ukiah, CA 95482
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals