CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Goshen Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $420
  • Cash Discount Price: $2,797
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Goshen Hospital is $420. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,797. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.18x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$2,797

Average discount available for prompt cash payment at this facility.

Insurance Median
$420

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: $2,797 (785%)
Insurance Median: $420 (118%)
Cash: $2,797 (785% of Medicare)
Ins. Median: $420 (118% 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.

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
Advantage Health Solutions $420 118%
Aetna $420 118%
Atrio Health Plans $420 118%
Bc Federal Employee $420 118%
Bc Mcr Advantage Ppo $420 118%
Blue Cross Blue Shield $420 - $1,168 118%
Buckeye Health Plan $420 118%
Cigna $420 118%
Coventry Health And Life $420 118%
Emblem Health $420 118%
Freedom Healthcare $420 118%
Geisinger Health Plan $420 118%
Health First $420 118%
Healthspring $420 118%
Humana $420 118%
Iehp Empire Health Plan $420 118%
Independent Care Health Plan $420 118%
Kaiser Permanente $420 118%
Mcr Advantra Freedom $420 118%
Mcr Allwell Mhs $420 118%
Mcr Banner Health $420 118%
Mcr Complete $420 118%
Mcr Complete Ppo $420 118%
Mcr Complete Wellmed $420 118%
Mcr Health Alliance $420 118%
Mcr Health Partners Plans $420 118%
Mcr Medical Mutual Of Ohio $420 118%
Mcr Passport Advantage $420 118%
Mcr Secure Horizons Ppo $420 118%
Mcr Texan Plus $420 118%
Mcr Upmc For Life $420 118%
Medicare (plans) $420 - $445 118%
Meridian Complete $420 118%
Optimum Healthcare $420 118%
Paramount Elite $420 118%
Primetime Health Plan $420 118%
Simply Complete Hmo $420 118%
The Umwa H&R Funds $420 118%
Todays Options Pyramid Life $420 118%
Trillium Advantage $420 118%
Ucare For Seniors $420 118%
Ucare Minnesota $420 118%
UnitedHealthcare $420 - $1,001 118%
Wellcare $420 118%
Champva $432 121%
Tricare $432 121%
Mcr Devoted Health Plan $445 125%
Mcr Provider Partners Hlth Pln $475 133%
Ambetter / Centene $605 170%
Mkt Caresource $605 170%
All Savers $1,001 281%
Golden Rule Insurance 2Nd $1,001 281%
Oxford Health $1,001 281%
Uhclic $1,001 281%
Uhss $1,001 281%
Bc Allied $1,168 328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals