CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: St Joseph's Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,229
  • Cash Discount Price: $5,075
  • vs. Medicare Baseline: 11.86x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St Joseph's Hospital is $4,229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,075. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.86x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$5,075

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,229

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: $5,075 (1424%)
Insurance Median: $4,229 (1186%)
Cash: $5,075 (1424% of Medicare)
Ins. Median: $4,229 (1186% 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 1186% of the Medicare baseline (a markup of 1086%). 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
Molina Healthcare $307 - $1,410 86%
Meridian Health Plan $321 - $642 90%
Cigna $1,190 334%
UnitedHealthcare $1,315 - $7,049 369%
Caterpillar, Inc. $1,315 369%
Blue Cross Blue Shield $1,410 396%
Aetna $1,410 - $4,927 396%
Humana $1,410 396%
Sae Hospice $1,410 396%
Clear Spring Health of Illinois $1,410 396%
Amish Community $1,974 554%
Naphcare $2,961 831%
Celtic Insurance Company $3,102 870%
Hopetrust $3,524 989%
Claim Doc $3,524 989%
Wellfirst $4,513 1266%
First Health $5,209 1461%
Healthlink $5,992 1681%
Multiplan/Phcs $5,992 1681%
Provider Network of America $6,344 1780%
Healthcare Finest Network (Hfn) $6,344 1780%
Health Alliance Medical Plans $7,049 1978%
Interplan $7,049 1978%
Healthscope $7,049 1978%
Illinois Breast and Cervical Cancer Program $7,049 1978%
Consociate Group $7,049 1978%
Current Health Solutions $7,049 1978%
Mental Health Network $7,049 1978%
Qtc Medical Group of Illinois $7,049 1978%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals