CT scan, abdomen and pelvis (with contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $740
- Cash Discount Price: $779
- vs. Medicare Baseline: 2.08x 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 208% of the Medicare baseline (a markup of 108%). 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 |
|---|---|---|
| Tricare | $624 | 175% |
| Humana | $709 | 199% |
| Aetna | $721 - $779 | 202% |
| UnitedHealthcare | $740 | 208% |
| Hpk-All Plans | $740 | 208% |
| Medicaid / KanCare | $779 | 219% |
Consumer Guidance & Cost Commentary
For the CT scan of the abdomen and pelvis with contrast at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $779.00, which matches the facility's gross charge and the median amount paid by Medicaid/KanCare. While the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates for commercial payers like Aetna and UnitedHealthcare range from $709 to $779. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate aligns with the highest negotiated amounts. Patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these can reduce the final bill by 20% to 50% if paid upfront.
When evaluating this cost, it is essential to compare rates against the Medicare benchmark rather than the facility's gross charge, as the latter often obscures the true cost. The Medicare amount for this procedure is $356.43, and the facility's negotiated rate of $740.00 represents a significant markup above this federal baseline. While the data does not provide specific state or county average comparisons for this CPT code, the principle of Medicare benchmarking remains the most reliable method for assessing whether a commercial rate is fair. To ensure you are not overcharged, request an itemized billing audit to confirm there are no unbundled codes or services not rendered, and always check your deductible status before using insurance to avoid unexpected out-of-pocket expenses.