CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Jeff Davis Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $5,433
  • Cash Discount Price: $2,571
  • vs. Medicare Baseline: 15.24x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Jeff Davis Hospital is $5,433. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,571. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 15.24x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.
Cash / Self-Pay
$2,571

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,433

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: $2,571 (721%)
Insurance Median: $5,433 (1524%)
Cash: $2,571 (721% of Medicare)
Ins. Median: $5,433 (1524% 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 1524% of the Medicare baseline (a markup of 1424%). 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
Pen_Network $436 122%
Medicaid / KanCare $1,246 - $4,448 350%
Humana $1,271 - $7,053 357%
Peach_State $1,271 - $1,650 357%
Wellcare $1,271 - $1,650 357%
Medicare (plans) $1,982 - $2,598 556%
Blue Cross Blue Shield $2,021 - $6,223 567%
Care_Improvement_Plus $2,021 - $2,624 567%
Coventry_Hmo $4,474 - $5,808 1255%
Coventry_Pos $4,474 - $5,808 1255%
Uhc_Hmo $4,794 - $6,223 1345%
Uhc_Indemnity $4,794 - $6,223 1345%
Uhc_Ppo $4,794 - $6,223 1345%
Coventry_Ppo $4,922 - $6,389 1381%
Beech_Street $5,114 - $6,638 1435%
Care_Source $5,114 - $6,638 1435%
Cigna $5,114 - $6,638 1435%
One_Health_Ppo $5,114 - $6,638 1435%
Choicecare $5,433 - $7,053 1524%
Community_Care_Network $5,433 - $7,053 1524%
Georgia_Hospital_Network $5,433 - $7,053 1524%
Industry_Buying_Group $5,433 - $7,053 1524%
Novanet $5,433 - $7,053 1524%
Principal_Health_Care_Of_Georgia $5,433 - $7,053 1524%
Three_Rivers_Provider_Network $5,433 - $7,053 1524%
Usa_Managed_Care $5,433 - $7,053 1524%
Memorial_Health_Partners $5,753 - $7,468 1614%
Tricare $5,945 - $7,717 1668%
Multiplan $6,072 - $7,883 1704%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 163 South Tallahassee Street, Hazlehurst, GA 31539
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals