CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Franklin General Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $1,828
  • Cash Discount Price: $3,896
  • vs. Medicare Baseline: 5.13x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Franklin General Hospital is $1,828. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,896. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.13x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.
Cash / Self-Pay
$3,896

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,828

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: $3,896 (1093%)
Insurance Median: $1,828 (513%)
Cash: $3,896 (1093% of Medicare)
Ins. Median: $1,828 (513% 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 513% of the Medicare baseline (a markup of 413%). 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
Wellmark Hmo $1,042 292%
Wellmark Ppo - All Other Plans $1,146 322%
Medical Associates Mcare $1,732 486%
Mount Carmel Hp-All Plans $1,732 486%
Tricare $1,732 486%
UnitedHealthcare $1,732 - $3,597 486%
Amerigroup Mcare $1,749 491%
Wellmark Mcr Adv $1,749 491%
Molina Mcare $1,801 505%
Ambetter / Centene $1,810 - $2,771 508%
American Hp Iowa - All Plans $1,818 510%
Amerigroup Mcaid - All Other Plans $1,828 513%
Molina Mcaid - All Other Plans $1,837 515%
Centivo - All Plans $2,597 729%
Medical Ass Hosp Employer Group $2,597 729%
Oscar - All Plans $2,597 729%
Midlands Choice-All Plans $3,030 850%
Medical Associates Hp-All Other Plans $3,680 1032%
Preferred Health Choices-All Plans $3,680 1032%
Splashlight Llc-All Plans $3,680 1032%
Aetna $4,026 - $4,113 1130%
Multiplan-All Plans $4,113 1154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1720 Central Avenue East, Hampton, IA 50441
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals