CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Pulaski Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $277
Cash Discount Price: $2,070
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Pulaski Memorial Hospital is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,070. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.78x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$2,070

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: $2,070 (581%)

Insurance Median: $277 (78%)

Cash: $2,070 (581% 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.

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
UnitedHealthcare	$77 - $4,472	22%
Ambetter / Centene	$80 - $1,755	22%
Blue Cross Blue Shield	$80 - $3,642	22%
Caresource Mcaid Hip	$80 - $1,755	22%
Caresource Mcare Hmo	$80 - $1,755	22%
Cenpatico Mcaid Hip	$80 - $1,755	22%
Humana	$80 - $4,551	22%
Mdwise Mcaid Hcc	$80 - $162	22%
Mdwise Mcaid Hhw	$80 - $162	22%
Mdwise Mcaid Hip - All Other Plans	$80 - $1,755	22%
Mhs Mcaid Hip	$80 - $1,755	22%
Mhs Mcare Allwell	$80 - $1,772	22%
Multiplan - All Plans	$80 - $5,095	22%
Caresource Exch Hmo Hix - All Other Plans	$101 - $2,194	28%
Cigna	$105 - $5,378	29%
Sagamore - All Other Plans	$105 - $4,279	29%
Sagamore Rose Acre	$105 - $4,217	29%
Encore Ppo - All Other Plans	$122 - $4,812	34%
Community Health Alliance - All Plans	$159 - $5,038	45%
Caresource Mcaid Hhw	$162 - $277	45%
Cenpatico Mcaid Hhw - All Other Plans	$162 - $277	45%
Mhs Mcaid Hhw/Hcc	$162 - $277	45%
Encore Workers Comp	$227 - $5,095	64%
Aetna	$2,038	572%

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 $2,070.
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 Pulaski Memorial 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.