CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Valley Children's Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,976
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 13.96x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Valley Children's Hospital is $4,976. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 13.96x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,976

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%)
Insurance Median: $4,976 (1396%)
Ins. Median: $4,976 (1396% 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 1396% of the Medicare baseline (a markup of 1296%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Allcare Ipa $282 79%
UnitedHealthcare $331 - $844 93%
Dignity Ipa_Formerly Img $395 111%
La Salle Ipa $395 111%
Sante Ipa $395 111%
Kaiser $409 - $6,498 115%
Central Valley Medical Providers Ipa $423 - $4,998 119%
Sequoia Health Ipa $423 119%
Univseral Healthcare Ipa $423 119%
United Physicians Network Ipa $437 123%
Community Care Ipa $445 125%
Adventist $497 139%
Blue Cross Blue Shield $510 - $2,360 143%
Cencal Health $557 156%
Kern Family Health Care $563 158%
Central California Alliance For Health $573 161%
Health Net $3,518 - $6,546 987%
Dignity Health Central Coast $4,954 1390%
Community Health $5,498 1543%
Stanislaus Partners In Health $5,498 1543%
Physicians Choice Medical Group $5,598 1571%
Health Plan Of San Joaquin $5,998 1683%
Fowler Packing $6,198 1739%
Dignity (Formerly Managed Care Systems) $6,298 1767%
Kern Legacy $6,498 1823%
Blue Shield $6,677 - $7,585 1873%
Aetna $6,698 1879%
First Health Formerly Coventry $7,398 2076%
Bakersfield Family Medical Group $7,498 2104%
Network By Design $7,748 2174%
Community Care Health Plan $7,995 2243%
Health Smart $7,998 2244%
Key Medical Ipa $7,998 2244%
Sutter Health $8,497 2384%
Multiplan $9,564 2683%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens