CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Fairview Park Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $917
  • Cash Discount Price: $15,781
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Fairview Park Hospital is $917. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,781. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.57x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.
Cash / Self-Pay
$15,781

Average discount available for prompt cash payment at this facility.

Insurance Median
$917

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: $15,781 (4428%)
Insurance Median: $917 (257%)
Cash: $15,781 (4428% of Medicare)
Ins. Median: $917 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Blue Cross Blue Shield $113 - $511 32%
Health One Alliance $351 98%
Ambetter / Centene $421 118%
Core Resources $424 119%
Aetna $460 - $8,700 129%
United $828 - $7,101 232%
Prime Health $898 252%
Employer'S Health Network $917 257%
Rockport United Network $917 257%
Identity Mco $936 263%
Synergy Health Network $936 263%
Amerigroup $2,115 593%
Nhc Advantage $2,998 841%
Pruitt Health $2,998 841%
Peach State $3,156 885%
Wellcare $3,156 885%
Memorial Health Plan $3,472 974%
Americas 1St Choice $4,419 1240%
Leavitt Risk Partners $4,734 1328%
Dodge County Hospital $7,890 2214%
American Steel Products $13,414 3763%
City Of Eastman $13,414 3763%
Dodge Co Board Of Commissioners $13,414 3763%
Graham Brothers Construction $13,414 3763%
Multiplan $14,203 3985%
Novanet $14,203 3985%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Industrial Boulevard, Dublin, GA 31021
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals