CT scan, abdomen and pelvis (with contrast)
Facility: Kiowa County Memorial Hospital
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $1,202
- Cash Discount Price: $1,148
- vs. Medicare Baseline: 3.37x 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 337% of the Medicare baseline (a markup of 237%). 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 | $458 - $1,202 | 128% |
| UnitedHealthcare | $1,081 - $1,350 | 303% |
| Health Partners Of Ks-All Plans | $1,188 | 333% |
| Celtic Comml Exchange-All Other Plans | $1,202 | 337% |
| Aetna | $1,202 | 337% |
| Humana | $1,202 | 337% |
| Medica Prime Mcare Cost-All Plans | $1,202 | 337% |
| Medicaid / KanCare | $1,350 | 379% |
| Providrs Care/Wppa-All Plans | $2,025 | 568% |
Consumer Guidance & Cost Commentary
For the CT scan of the abdomen and pelvis with contrast at Kiowa County Memorial Hospital in Greensburg, Kansas, the facility's cash price of $1,148 is notably lower than the median negotiated rate of $1,202 paid by most commercial insurers. While the facility is a Critical Access Hospital with government local ownership, the data indicates that patients with high-deductible plans might save money by paying the cash price directly, as the insurance negotiated rates often exceed the cash amount due to administrative overhead and contract structures. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between payers, and you should explicitly ask the hospital about self-pay or prompt-pay discounts before check-in to ensure you are not automatically enrolled in a higher insurance billing cycle.
When comparing this facility's pricing to broader benchmarks, the Medicare amount for this procedure is $356.43, which serves as the objective baseline for evaluating the true cost of care. The facility's cash price represents a markup of approximately 3.4 times the Medicare rate, which aligns with the typical range where fair pricing is defined as 120% to 150% of Medicare, though commercial negotiated rates often average between 200% and 300% of this baseline. Given that over 80% of hospital bills contain errors, it is advisable to request a full itemized CPT-coded bill rather than accepting a summary invoice, and to dispute any balance billing immediately if you receive a surprise charge, as federal protections under the No Surprises Act may apply depending on the nature of the service and your network status.