CT scan, abdomen and pelvis (with contrast)
Facility: Holton Community Hospital
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $1,249
- Cash Discount Price: $1,129
- vs. Medicare Baseline: 3.50x 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 350% of the Medicare baseline (a markup of 250%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $453 | 127% |
| UnitedHealthcare | $798 - $1,505 | 224% |
| Aetna | $798 - $1,505 | 224% |
| Humana | $806 | 226% |
| Kansas Superior Select - All Plans | $814 | 228% |
| Preferred Health Freedom | $1,249 | 350% |
| Preferred Health Professionals | $1,249 | 350% |
| Preferred Health Fn Select - All Other Plans | $1,249 | 350% |
| Wppa Providers - All Plans | $1,430 | 401% |
| Medicaid / KanCare | $1,505 | 422% |
Consumer Guidance & Cost Commentary
For this CT scan of the abdomen and pelvis at Holton Community Hospital, the negotiated rates for in-network payers like UnitedHealthcare and Aetna range from $798 to $1,505, which is significantly higher than the cash price of $1,129. While commercial insurance contracts often include administrative overhead that inflates these rates, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that Medicaid/KanCare rates are fixed at $1,249, and while this facility is a Critical Access Hospital in Kansas, the data provided does not include specific county or state average comparisons to contextualize these figures against regional pricing norms.
To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered, which are common sources of billing errors. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, since this facility offers a prompt-pay discount for upfront cash payments, you should contact the hospital directly to confirm their self-pay rates and ask for a waiver of insurance submission to avoid automatic claims processing that could void any cash savings.