CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Johnson Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $1,041
  • Cash Discount Price: $897
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Johnson Memorial Hospital is $1,041. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $897. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.92x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$897

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,041

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: $897 (252%)
Insurance Median: $1,041 (292%)
Cash: $897 (252% of Medicare)
Ins. Median: $1,041 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Connecticut Dept Of Correction $386 108%
Allegiance $391 110%
Cigna $391 - $1,271 110%
Health Partners $391 110%
Magnacare $391 110%
Aetna $410 - $730 115%
Blue Cross Blue Shield $410 - $1,041 115%
Medicare (plans) $410 - $431 115%
UnitedHealthcare $410 - $1,630 115%
Cca Senior Care Options $418 117%
Fallon Health $544 153%
Geha $611 171%
Harvard Pilgrim Healthcare $611 171%
1199 National Benefit Fund $730 205%
Allied Benefit Systems $730 205%
Gravie Admin Services $730 205%
Hap $730 205%
Luminare Health $730 205%
Meritain $730 205%
Nippon Life Ins $730 205%
Webtpa $730 205%
Claimdoc $878 246%
Diversified Administrators $878 246%
Innovative Health Plan Ii $878 246%
Centivo $974 273%
Bcn Domestic $1,041 292%
Blue Benefit Administrators Of Massachusetts $1,041 292%
Blue Care Network $1,041 292%
Blue Distinction Transplant $1,041 292%
Blue Shield - Ca $1,041 292%
Blue Shield - Id (Regence) $1,041 292%
Blue Shield - Ny Highmark Northeastern $1,041 292%
Blue Shield - Ny Highmark Western $1,041 292%
Blue Shield - Pa (Highmark) $1,041 292%
Blue Shield - Wa (Regence) $1,041 292%
Health Choices $1,041 292%
Kaiser Domestic $1,041 292%
Pre-Employment $1,041 292%
Unicare $1,041 292%
Wc Domestic $1,041 292%
Wellpoint $1,041 292%
Health New England $1,060 297%
Connecticare $1,295 - $1,618 363%
Prime Health Services $1,304 366%
Allied National Global Care $1,353 380%
Asrm - Reliance Standard Life Insurance $1,353 380%
Christian Care Ministry $1,353 380%
Dean Health $1,353 380%
Family Life Insurance Company $1,353 380%
Ghc Scw $1,353 380%
International Benefit Administrators $1,353 380%
Lifetime Benefit Solutions $1,353 380%
Manhattan Life $1,353 380%
Medi Share $1,353 380%
Multiplan $1,353 380%
Mvp $1,353 380%
Pai $1,353 380%
Pan-American Life $1,353 380%
Paramount Hmo $1,353 380%
Phcs $1,353 380%
Trinity Health Share $1,353 380%
Health Smart $1,386 389%
United Behavioral Health Eap $1,630 457%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals