CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Jacksonville Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $4,406
Cash Discount Price: $7,583
vs. Medicare Baseline: 12.36x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Jacksonville Memorial Hospital is $4,406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,583. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 12.36x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$7,583

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,406

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: $7,583 (2127%)

Insurance Median: $4,406 (1236%)

Cash: $7,583 (2127% of Medicare)

Ins. Median: $4,406 (1236% 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 1236% of the Medicare baseline (a markup of 1136%). 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	$263 - $7,822	74%
Coventry	$278 - $1,232	78%
Health Alliance	$278 - $5,319	78%
Humana	$278 - $6,672	78%
Medicare (plans)	$278 - $1,232	78%
Tricare	$278 - $1,426	78%
UnitedHealthcare	$292 - $5,632	82%
Medicaid / KanCare	$595	167%
Molina Healthcare	$595	167%
Corvel/Corcare	$884 - $4,078	248%
Illinois Workers Compensation	$949 - $4,161	266%
Healthlink	$1,050 - $6,649	295%
Health Alliance Mh Employee Plan	$3,378 - $3,598	948%
Commercial Workers Compensation	$3,712 - $3,953	1041%
Current Health Network	$4,039 - $5,866	1133%
6 Degrees Health	$4,406 - $4,693	1236%
Hope Trust	$4,406 - $4,693	1236%
Hst	$4,406 - $4,693	1236%
Cigna	$5,089 - $5,421	1428%
Aetna	$5,133 - $6,258	1440%
Phcs/Multiplan	$6,610 - $7,040	1855%
Hfn	$6,977 - $7,431	1957%
Liability	$7,344 - $7,822	2060%

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 $7,583.
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 Jacksonville 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.