CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $389
  • Cash Discount Price: $2,272
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Mt Sinai Hospital Medical Center is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,272. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.09x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$2,272

Average discount available for prompt cash payment at this facility.

Insurance Median
$389

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: $2,272 (637%)
Insurance Median: $389 (109%)
Cash: $2,272 (637% of Medicare)
Ins. Median: $389 (109% 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
Partners In Hlth - All Plans $85 - $2,512 24%
Blue Cross Blue Shield $95 - $3,993 27%
Healthlink Hmo $106 - $3,140 30%
Healthlink Ppo - All Other Plans $106 - $3,140 30%
Compsych Ip/Op Only - All Plans $128 - $3,768 36%
Hfn Platinum $138 - $4,082 39%
Multiplan Primary Ntwrk/Phcs - All Other Plans $149 - $4,396 42%
Hfn Epo $170 - $5,024 48%
Multiplan Complementary Ntwrk $170 - $5,024 48%
Hfn Ppo - All Other Plans $187 - $5,526 52%
Ambetter / Centene $223 - $6,594 63%
Oscar - All Plans $234 - $6,594 66%
Cigna $263 - $7,762 74%
Tricare $363 102%
Va Healthnet - All Plans $363 102%
Advocate Physician Prtnrs Mcr $374 105%
Cenpatico Illinicare Dual $374 105%
Cenpatico Illinicare Mcr - All Other Plans $374 105%
Humana $374 - $19,719 105%
Lawndale Christian - All Plans $374 - $602 105%
Meridian/Harmony D-Snp - All Plans $374 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $374 105%
UnitedHealthcare $374 - $893 105%
Harmony Behavioral Htlh - All Plans $385 108%
Zing Mcr Adv - All Plans $389 109%
Molina Mcr - All Other Plans $393 110%
Advocate Physician Prtnrs - All Other Plans $411 115%
Aetna $477 - $14,192 134%
Family Health Network Mcaid - All Plans $477 134%
Molina Mcaid $501 141%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals