CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Hamilton Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,684
Cash Discount Price: $3,112
vs. Medicare Baseline: 7.53x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Hamilton Memorial Hospital is $2,684. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,112. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.53x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.

Cash / Self-Pay

$3,112

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,684

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: $3,112 (873%)

Insurance Median: $2,684 (753%)

Cash: $3,112 (873% of Medicare)

Ins. Median: $2,684 (753% 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 753% of the Medicare baseline (a markup of 653%). 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
Aetna	$282 - $3,295	79%
Blue Cross Blue Shield	$282 - $3,332	79%
Health Alliance	$282 - $2,929	79%
Medicare (plans)	$282 - $1,465	79%
UnitedHealthcare	$282 - $2,622	79%
Wellcare	$282 - $1,465	79%
Healthlink	$787 - $910	221%
Medicaid / KanCare	$1,362 - $1,465	382%
Alliance Coal	$1,465	411%
Humana	$1,465	411%
Healthscope	$2,563	719%
Wellfirst (Ssmhic)	$2,563	719%
Hope Trust	$2,746	770%
Cigna	$2,874	806%
Hfn, Inc	$2,929 - $3,295	822%
Multiplan	$3,112	873%
Siho	$3,295	924%
Three Rivers Provider	$3,295	924%
Healthsmart	$3,478	976%
Stratose	$3,478	976%

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 $3,112.
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 Hamilton Memorial 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.