CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $6,407
  • Cash Discount Price: $6,030
  • vs. Medicare Baseline: 17.98x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Memorial Hospital is $6,407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,030. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 17.98x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.
Cash / Self-Pay
$6,030

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,407

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: $6,030 (1692%)
Insurance Median: $6,407 (1798%)
Cash: $6,030 (1692% of Medicare)
Ins. Median: $6,407 (1798% 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 1798% of the Medicare baseline (a markup of 1698%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $558 - $4,157 157%
Consociate $558 - $6,407 157%
Cigna $1,000 - $3,326 281%
Humana $1,094 - $7,538 307%
Blue Cross Blue Shield $1,358 - $4,157 381%
First Health Network $1,374 - $6,709 385%
Health Alliance $2,111 - $7,538 592%
Meridian $2,111 - $7,538 592%
Molina $2,111 - $7,538 592%
UnitedHealthcare $2,111 - $7,538 592%
Healthlink $3,300 - $6,407 926%
Private Healthcare Systems $6,407 1798%
Integrated Health Plan $6,633 1861%
Health Dynamics $6,784 1903%
Health Payors Org $6,784 1903%
Iowa Health Solutions $6,784 1903%
Multiplan $6,784 1903%
Preferred Plan Inc $6,784 1903%
Three Rivers Provider Network $6,784 1903%
Health First Network $6,860 1925%
Pponext $6,860 1925%
Corvel $7,161 2009%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1454 N County Road 2050 E, Carthage, IL 62321
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals