CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: St Lukes Regional Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $316
  • Cash Discount Price: $625
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St Lukes Regional Medical Center is $316. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.89x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.
Cash / Self-Pay
$625

Average discount available for prompt cash payment at this facility.

Insurance Median
$316

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: $625 (175%)
Insurance Median: $316 (89%)
Cash: $625 (175% of Medicare)
Ins. Median: $316 (89% 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.

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
Nebraska Total Care $53 - $476 15%
Aetna $80 - $873 22%
Blue Cross Blue Shield $81 - $694 23%
Molina $81 - $355 23%
Amerivantage $84 - $365 24%
Humana $84 - $365 24%
UnitedHealthcare $84 - $953 24%
Avera Health Plan $120 - $1,190 34%
Wellmark Uph Self-Funded $166 - $590 47%
Cigna $168 - $1,152 47%
Health Partners Open Network $183 - $650 51%
Amerigroup $316 89%
Iowa Total Care $316 89%
Medica Exchange Inspire $945 265%
Medica Exchange Insure $1,058 297%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2720 Stone Park Boulevard, Sioux City, IA 51104
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals