CT scan, abdomen and pelvis (with contrast)
Facility: Decatur Health
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $852
- Cash Discount Price: $1,005
- vs. Medicare Baseline: 2.39x 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 239% of the Medicare baseline (a markup of 139%). 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 | $589 | 165% |
| Wppa/Providrs Care- All Plans | $670 | 188% |
| UnitedHealthcare | $681 - $852 | 191% |
| Humana | $688 | 193% |
| Midlands Choice- All Plans | $1,005 | 282% |
| Aetna | $1,005 - $1,116 | 282% |
| Medicaid / KanCare | $1,128 | 316% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis with contrast at Decatur Health in Oberlin, KS, the facility's cash price of $1,005 is lower than the state average, which is $1,116. While commercial insurance plans like Aetna and UnitedHealthcare have negotiated rates ranging from $681 to $1,116, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $1,005 rate is significantly lower than the gross chargemaster of $1,116 and below the median negotiated rate of $852. It is important to verify your specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price can lead to unexpected costs if your insurer negotiates a higher rate than the cash option.
To minimize out-of-pocket expenses, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, this service's Medicare benchmark of $356.43 provides a clear baseline for evaluating pricing; commercial rates are often marked up significantly above this federal standard, with the cash price representing a fairer value than the full chargemaster. If you receive a bill after using insurance, request a detailed, itemized statement to review for errors or unbundled codes, as over 80% of hospital bills contain discrepancies that can be corrected. Always ensure you have a signed waiver of insurance submission if you choose to pay cash, as