CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Wilcox Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $453
Cash Discount Price: $2,090
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Wilcox Memorial Hospital is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,090. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.27x the Medicare baseline. Located in 3-3420 Kuhio Highway, Lihue, HI.

Cash / Self-Pay

$2,090

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

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: $2,090 (586%)

Insurance Median: $453 (127%)

Cash: $2,090 (586% of Medicare)

Ins. Median: $453 (127% 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
Hmsa	$181 - $901	51%
UnitedHealthcare	$181	51%
Alohacare	$214 - $453	60%
Ohana	$220 - $979	62%
Mdx	$331 - $453	93%
Devoted	$475	133%
Hwmg/Hmaa	$538	151%
Pac Admin	$714	200%
Verdegard	$874	245%
Hcha	$2,787	782%
Kaiser	$2,787	782%
Multiplan	$2,787 - $2,961	782%

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 $2,090.
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 Wilcox Memorial Hospital 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.