CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $444
Cash Discount Price: $4,479
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at UMass Memorial Health - Harrington Hospital is $444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,479. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.25x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$4,479

Average discount available for prompt cash payment at this facility.

Insurance Median

$444

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $4,479 (1257%)

Insurance Median: $444 (125%)

Cash: $4,479 (1257% of Medicare)

Ins. Median: $444 (125% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Cigna	$418 - $3,216	117%
Institution [10406]	$418 - $423	117%
Mgb Mcr [10124]	$418 - $423	117%
Tufts Us Family [11203]	$423	119%
Champva [11001]	$424	119%
Blue Cross Blue Shield	$432 - $1,695	121%
Aetna	$439 - $4,166	123%
Commonwealth Care Alliance [10103]	$439 - $444	123%
Fallon Mcr Supp [20202]	$439 - $444	123%
Fallon Mcr [10105]	$439 - $444	123%
Tufts Mcr [10112]	$439 - $444	123%
UnitedHealthcare	$444 - $4,166	125%
Senior Whole Health [10110]	$453	127%
Hsno/Free Care [10801]	$681	191%
Tufts Connectorcare [10507]	$711 - $720	199%
Wellpoint [11112]	$953	267%
Workers Compensation [20501]	$2,032	570%
Medicaid / KanCare	$2,166	608%
Hne [11108]	$2,711	761%
First Health Network [11120]	$3,124	876%
Evernorth Behavioral Health [27]	$3,333	935%
Connecticare [11105]	$4,166	1169%
Fallon Carelon Hlth [28]	$4,166	1169%
Fallon Mcaid Carelon Hlth [29]	$4,166	1169%
Grants [20507]	$4,166	1169%
Masshealth Mcd Mbhp [38]	$4,166	1169%
Wellsense Mcaid Carelon Hlth [21]	$4,166	1169%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $4,479.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Health - Harrington Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.