CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Pinckneyville Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,947
Cash Discount Price: $5,160
vs. Medicare Baseline: 5.46x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Pinckneyville Community Hospital is $1,947. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,160. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.46x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$5,160

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,947

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: $5,160 (1448%)

Insurance Median: $1,947 (546%)

Cash: $5,160 (1448% of Medicare)

Ins. Median: $1,947 (546% 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 546% of the Medicare baseline (a markup of 446%). 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
Umwa Mcr Adv - All Plans	$84 - $1,960	24%
UnitedHealthcare	$84 - $4,343	24%
Wellcare Mcr Adv - All Plans	$84 - $1,960	24%
Aetna	$86 - $4,766	24%
Humana	$86 - $1,960	24%
Cigna	$101 - $4,369	28%
Ambetter / Centene	$165 - $1,659	46%
Blue Cross Blue Shield	$165 - $3,813	46%
Medicaid / KanCare	$165 - $1,659	46%
Healthlink Hmo	$434 - $4,157	122%
Healthlink Ppo - All Other Plans	$434 - $4,369	122%
Phcs Savility	$595 - $4,502	167%
Multiplan - All Plans	$630 - $4,766	177%
Phcs - All Other Plans	$630 - $4,343	177%
Healthlink Work Comp	$4,257 - $4,369	1194%

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 $5,160.
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 Pinckneyville Community 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.