CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Adventist Health Mendocino Coast

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $420
Cash Discount Price: $2,092
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Adventist Health Mendocino Coast is $420. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,092. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.18x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$2,092

Average discount available for prompt cash payment at this facility.

Insurance Median

$420

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: $2,092 (587%)

Insurance Median: $420 (118%)

Cash: $2,092 (587% of Medicare)

Ins. Median: $420 (118% 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.

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
Cigna	$85 - $4,680	24%
Tricare	$85 - $2,940	24%
UnitedHealthcare	$85 - $4,856	24%
Blue Cross Blue Shield	$90 - $1,736	25%
Ah Employee Health Plan - All Plans	$94 - $3,120	26%
Healthnet - All Plans	$124 - $3,906	35%
Blue Shield Epn	$157 - $2,268	44%
Blue Shield - All Other Plans	$166 - $4,608	47%
Medi-Cal	$282 - $404	79%
Ahcc - All Plans	$339 - $5,400	95%
Beech Street - All Plans	$339 - $5,400	95%
Great West Hmo/Pos/Epo/Oa	$339 - $3,900	95%
Great West Ppo - All Other Plans	$339 - $4,200	95%
Multiplan - All Plans	$339 - $4,200	95%
Partnership Hp Mcal-All Plans	$339 - $1,213	95%

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 $2,092.
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 Adventist Health Mendocino Coast 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.