CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Unity Physicians Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $18,988
Cash Discount Price: Unavailable
vs. Medicare Baseline: 53.27x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Unity Physicians Hospital is $18,988. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 53.27x the Medicare baseline. Located in 4455 Edison Lakes Pkwy, Mishawaka, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,988

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%)

Insurance Median: $18,988 (5327%)

Ins. Median: $18,988 (5327% 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 5327% of the Medicare baseline (a markup of 5227%). 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	$162 - $56,407	45%
Medicaid / KanCare	$162	45%
Mhs Hoosier Care Connect	$162	45%
Aarp Supplemental	$328 - $36,351	92%
Aetna	$328 - $36,351	92%
Cigna	$328 - $36,351	92%
Department Of Va	$328 - $36,351	92%
Medicare (plans)	$328 - $36,351	92%
Mhs Healthy Indiana Plan	$328 - $36,351	92%
Railroad Retirement	$328 - $36,351	92%
UnitedHealthcare	$328 - $76,226	92%
Three Rivers Provider Network	$394 - $43,621	111%
Humana	$459 - $100,000	129%
Encore	$591 - $65,431	166%
Provider Network Of America	$656 - $72,702	184%
Nalc	$1,219 - $76,226	342%
Sagamore Health Network	$1,219 - $76,226	342%
Multiplan	$1,321	371%
Multiplan Wc	$1,626	456%
All Savers	$76,226	21386%
Medica	$76,226	21386%
Medica Ifb	$76,226	21386%
Oxford	$76,226	21386%

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 $X.
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 Unity Physicians 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.