CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Sheldon Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $3,604
Cash Discount Price: $4,469
vs. Medicare Baseline: 10.11x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Sheldon Medical Center is $3,604. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,469. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.11x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.

Cash / Self-Pay

$4,469

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,604

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: $4,469 (1254%)

Insurance Median: $3,604 (1011%)

Cash: $4,469 (1254% of Medicare)

Ins. Median: $3,604 (1011% 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 1011% of the Medicare baseline (a markup of 911%). 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
Sanford Health Plan Align	$1,592	447%
Ucare	$1,709 - $4,908	479%
Aetna	$1,726 - $4,854	484%
Blue Cross Blue Shield	$1,726	484%
Health Partners	$1,726 - $4,190	484%
Medicare (plans)	$1,726	484%
UnitedHealthcare	$1,726 - $4,664	484%
Primewest	$1,760	494%
Wellmark	$2,793 - $2,905	784%
Sanford Health Plan	$2,993 - $3,521	840%
Security Health Plan	$3,072	862%
Medica	$4,608 - $4,927	1293%
First Choice Health Network	$5,027	1410%
Healthez	$5,027	1410%
Multiplan	$5,027	1410%

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 $4,469.
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 Sanford Sheldon Medical Center 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.