CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Memorial Hospital and Health Care Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $277
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Memorial Hospital and Health Care Center is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.78x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$277

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: $112 (31%)
Insurance Median: $277 (78%)
Cash: $112 (31% of Medicare)
Ins. Median: $277 (78% 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
Blue Cross Blue Shield $67 - $601 19%
Aetna $80 - $527 22%
Caresource In Marketplace $80 - $468 22%
Humana $80 - $374 22%
Mdwise $80 - $285 22%
Mhs Hoosier Care Connect $80 - $285 22%
Tricare $80 - $318 22%
Chamber Care $82 23%
Encore $86 - $428 24%
Encore Elite + $86 - $898 24%
UnitedHealthcare $89 - $1,122 25%
Immergrun $96 - $332 27%
Ambetter / Centene $104 - $486 29%
Onecare $104 - $360 29%
Siho $104 - $360 29%
Patoka Valley $112 - $425 31%
Noncontracted $128 - $599 36%
Cigna $149 - $527 42%
Sagamore $149 - $527 42%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 W 9Th St, Jasper, IN 47546
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals