CT scan, abdomen and pelvis (with contrast)
Facility: Nmc Health
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $1,273
- Cash Discount Price: $1,425
- vs. Medicare Baseline: 3.57x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 357% of the Medicare baseline (a markup of 257%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bluestem Pace | $354 | 99% |
| Blue Cross Blue Shield | $480 | 135% |
| Leading Age | $566 | 159% |
| Medicaid / KanCare | $566 | 159% |
| Wppa | $1,120 | 314% |
| Occunet | $1,222 | 343% |
| Samaritan Ministries International | $1,323 | 371% |
| Medincrease Health Plan | $1,323 | 371% |
| Prime Health Services | $1,527 | 428% |
| Aetna | $1,678 | 471% |
| UnitedHealthcare | $1,832 | 514% |
| Cigna | $1,934 | 543% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Nmc Health in Newton, KS, the facility's cash price of $1,425 is notably lower than the state average, which sits at $1,678. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates as high as $1,832 and $1,934 respectively, these figures often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated amount can sometimes be significantly higher than the self-pay option. To secure the lowest possible cost, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The Medicare benchmark for this procedure is $356.43, providing a clear baseline for evaluating the facility's pricing markup. The gross chargemaster rate of $2,036 is substantially higher than the Medicare amount, illustrating how commercial rates can be inflated compared to the federal cost basis. If you are concerned about balance billing or unexpected charges, it is important to verify your network status before scheduling, as out-of-network services at in-network facilities can trigger additional costs. Furthermore, if you receive a summary bill, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written dispute.