CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Boone County Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,476
Cash Discount Price: $2,624
vs. Medicare Baseline: 4.14x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Boone County Hospital is $1,476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,624. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.14x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$2,624

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,476

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: $2,624 (736%)

Insurance Median: $1,476 (414%)

Cash: $2,624 (736% of Medicare)

Ins. Median: $1,476 (414% 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 414% of the Medicare baseline (a markup of 314%). 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
Tricare	$356	100%
Wellmark Hmo	$882	247%
Wellmark Ppo - All Other Plans	$969	272%
Choice Care Mcr Adv - All Plans	$1,345	377%
Humana	$1,345 - $2,952	377%
Iowa Hlth Adv - All Plans	$1,345	377%
Mt Carmel Hp - All Plans	$1,345	377%
UnitedHealthcare	$1,345 - $1,925	377%
Va Ccn-All Plans	$1,345	377%
Amerigroup Mcr Adv - All Other Plans	$1,358	381%
Aetna	$1,375 - $2,558	386%
Meridian Mcaid - All Plans	$1,476	414%
Iowa Total Care Mcaid - All Plans	$1,505	422%
Medicaid / KanCare	$1,520	426%
Healthsmart Accell Network	$2,296	644%
Medical Associates Hp-All Plans	$2,460	690%
Healthsmart Ppo - All Other Plans	$2,624	736%
Health Alliance-All Plans	$2,952	828%
Midlands Choice-All Plans	$3,017	846%
Mutually Preferred-All Plans	$3,116	874%

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 $2,624.
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 Boone County 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.