CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Virginia Gay Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,704
Cash Discount Price: $2,822
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Virginia Gay Hospital is $1,704. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,822. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.78x the Medicare baseline. Located in 502 North 9Th Avenue, Vinton, IA.

Cash / Self-Pay

$2,822

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,704

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: $2,822 (792%)

Insurance Median: $1,704 (478%)

Cash: $2,822 (792% of Medicare)

Ins. Median: $1,704 (478% 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 478% of the Medicare baseline (a markup of 378%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$266	75%
Medicaid / KanCare	$356 - $1,533	100%
Wellmark Hmo	$1,042	292%
Wellmark Ppo-All Other Plans	$1,146	322%
UnitedHealthcare	$1,182 - $1,704	332%
Va Ccn-All Plans	$1,286 - $1,324	361%
Health Alliance Mcr Adv	$1,355 - $1,396	380%
Medical Associates-All Plans	$2,606 - $2,684	731%
Cedar Valley Community Healthcare-All Plans	$2,736 - $2,818	768%
Humana	$2,780 - $2,863	780%
Health Partners-All Plans	$2,954 - $3,042	829%
Healthsmart-All Plans	$2,954 - $3,042	829%
Corvel-All Plans	$3,232 - $3,328	907%
Health Alliance-All Other Plans	$3,301 - $3,400	926%

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 $2,822.
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 Virginia Gay 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.