CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Daviess Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $407
Cash Discount Price: $1,379
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Daviess Community Hospital is $407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,379. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.14x the Medicare baseline. Located in 1314 E Walnut St, Washington, IN.

Cash / Self-Pay

$1,379

Average discount available for prompt cash payment at this facility.

Insurance Median

$407

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: $1,379 (387%)

Insurance Median: $407 (114%)

Cash: $1,379 (387% of Medicare)

Ins. Median: $407 (114% 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.

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	$80 - $3,730	22%
Blue Cross Blue Shield	$80 - $1,303	22%
Encore Ppo-All Plans	$80 - $850	22%
Humana	$80 - $488	22%
UnitedHealthcare	$84 - $3,133	24%
St. Vincent Health - All Plans	$88 - $2,424	25%
Patoka Valley-All Plans	$105 - $1,865	29%
Mdwise Marketplace-All Plans	$154 - $695	43%
Caresource Mcaid-All Plans	$162 - $210	45%
Hoosier Healthwise Mcaid-All Plans	$162 - $210	45%
Siho-All Plans	$189 - $3,357	53%
Sagamore Valley-All Plans	$204 - $3,618	57%

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 $1,379.
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 Daviess 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.