CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Jefferson County Health Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $50
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Jefferson County Health Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.14x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $65 (18%)
Insurance Median: $50 (14%)
Cash: $65 (18% of Medicare)
Ins. Median: $50 (14% 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
UnitedHealthcare $37 - $97 10%
Tricare $42 12%
Amerigroup Mcr Adv $43 12%
Humana $43 12%
Iowa Total Care Comm - All Other Plans $43 12%
Iowa Total Care Mcr $43 12%
Molina Mcr Adv $43 12%
Iowa Total Care Mcaid $45 13%
Molina Mcaid/Chip $45 13%
Medicaid / KanCare $46 13%
Aetna $53 - $97 15%
Medicare (plans) $53 15%
Midlands New Product $89 25%
Coventry Commercial Hmo $92 26%
Coventry Commercial Ppo - All Other Plans $97 27%
Midlands Choice-All Other Plans $97 27%
Molina Marketplace - All Other Plans $108 30%
Wellmark Hmo $902 253%
Wellmark Indemnity/Ppo - All Other Plans $993 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals