CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Witham Health Services

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,731
  • Cash Discount Price: $4,807
  • vs. Medicare Baseline: 13.27x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Witham Health Services is $4,731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,807. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 13.27x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.
Cash / Self-Pay
$4,807

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,731

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: $4,807 (1349%)
Insurance Median: $4,731 (1327%)
Cash: $4,807 (1349% of Medicare)
Ins. Median: $4,731 (1327% 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 1327% of the Medicare baseline (a markup of 1227%). 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
Blue Cross Blue Shield $162 - $5,407 45%
Mdwise Health In-All Plans $369 104%
Caresource Mcr Adv $376 105%
Aetna $380 - $5,082 107%
Caresource Indiana Marketplace-All Other Plans $701 197%
UnitedHealthcare $5,356 1503%
Phcs/Multiplan-All Plans $6,249 1753%
Sagamore-All Plans $6,318 1773%
Humana $6,386 1792%
Beech Street-All Plans $6,455 1811%
Encore-All Plans $6,524 1830%
Mhs Comml Exch-All Plans $17,168 4817%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2605 N Lebanon St, Lebanon, IN 46052
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals