CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Adventist Health Lodi Memorial

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $460
  • Cash Discount Price: $477
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Adventist Health Lodi Memorial is $460. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $477. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.29x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$477

Average discount available for prompt cash payment at this facility.

Insurance Median
$460

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: $477 (134%)
Insurance Median: $460 (129%)
Cash: $477 (134% of Medicare)
Ins. Median: $460 (129% 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 - $15,503 13%
Alignment Health Plan (Ahp)-All Plans $85 - $460 24%
Blue Shield Mcare Adv $85 - $460 24%
Healthnet Mcare $85 - $460 24%
Hp Of San Joaquin Mcr Adv $85 - $460 24%
Humana $85 - $460 24%
Knnex Health - All Plans $85 - $552 24%
Tricare $85 - $460 24%
UnitedHealthcare $85 - $7,151 24%
Hp Healthy Kids Pro Fee $89 25%
Ah Employee Health Plan - All Plans $94 - $828 26%
First Health- All Plans $102 - $5,500 29%
Bc Mcal $109 - $282 31%
Beech Street- All Plans $111 - $15,503 31%
Hp Of San Joaquin Ppo - All Other Plans $111 - $16,365 31%
Multiplan- All Plans $111 - $13,781 31%
Kaiser Commercial - All Other Plans $115 - $7,063 32%
Kaiser Mcr Adv $115 - $460 32%
Networks By Design- All Plans $115 - $3,500 32%
Healthnet- All Other Plans $124 - $8,460 35%
Western Growers- All Plans $130 - $12,888 36%
Blue Shield Epn - All Other Plans $157 - $5,581 44%
Blue Cross Blue Shield $161 - $2,098 45%
Blue Shield Non-Epn $166 - $5,788 47%
Celtic Ins Company - All Plans $282 - $453 79%
Kaiser Mcal $282 - $404 79%
Medi-Cal $282 - $404 79%
Hp Mcal Pro Fee $310 87%
Healthnet Mcal $338 - $578 95%
Hp Of San Joaquin Mcal $338 - $505 95%
Aetna $364 - $3,000 102%
Cca Health Plan Mcr Adv- All Plans $460 129%
Bright Health - All Plans $920 258%
Medcore(Omni Ipa) Op Only- All Plans $1,771 - $4,479 497%
Three Rivers Provider Network- All Plans $6,132 - $15,503 1720%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals