CT scan, abdomen and pelvis (with contrast)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $1,592
- Cash Discount Price: $3,086
- vs. Medicare Baseline: 4.47x 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 447% of the Medicare baseline (a markup of 347%). 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 | $480 | 135% |
| Aetna | $1,419 - $2,314 | 398% |
| UnitedHealthcare | $1,765 | 495% |
Consumer Guidance & Cost Commentary
For a CT scan of the abdomen and pelvis with contrast at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $3,086.00, which matches the facility's median paid amount. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range from $1,419 to $2,314, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans or those without insurance may find the cash rate more affordable than their insurance allowed amount, especially if the negotiated rate exceeds the cash price. It is important to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as paying upfront can sometimes bypass the higher administrative fees associated with insurance billing cycles.
This procedure's pricing is evaluated against the Medicare benchmark of $356.43, which serves as a scientifically validated baseline for the true cost of care. The commercial cash rate of $3,086.00 represents a significant markup over the Medicare amount, a common practice where commercial rates can average 200% to 300% of Medicare rates. To ensure you are not overcharged, you should request a full itemized bill that breaks down every CPT code and charge, as summary bills often obscure errors or unbundled services. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act 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.