CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Valley West Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $5,537
Cash Discount Price: $6,049
vs. Medicare Baseline: 15.53x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Valley West Community Hospital is $5,537. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,049. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 15.53x the Medicare baseline. Located in 11 East Pleasant Avenue, Sandwich, IL.

Cash / Self-Pay

$6,049

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,537

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: $6,049 (1697%)

Insurance Median: $5,537 (1553%)

Cash: $6,049 (1697% of Medicare)

Ins. Median: $5,537 (1553% 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 1553% of the Medicare baseline (a markup of 1453%). 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
Blue Cross Blue Shield	$1,642 - $7,061	461%
Global Excel [1712]	$1,642	461%
Humana	$1,642	461%
Aetna	$2,195 - $5,989	616%
Health'S Finest Network [126]	$3,889 - $7,346	1091%
The Alliance [1703]	$4,697	1318%
Choicecare [177]	$5,825	1634%
Healthlink [125]	$6,482	1819%
Multiplan/Phcs [142]	$6,914 - $8,642	1940%
First Health Plan [6034]	$8,642	2425%
UnitedHealthcare	$8,642	2425%

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 $6,049.
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 Valley West 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.