CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Newton-Wellesley Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $416
Cash Discount Price: $1,754
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Newton-Wellesley Hospital is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,754. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.17x the Medicare baseline. Located in 2014 Washington Street, Newton, MA.

Cash / Self-Pay

$1,754

Average discount available for prompt cash payment at this facility.

Insurance Median

$416

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: $1,754 (492%)

Insurance Median: $416 (117%)

Cash: $1,754 (492% of Medicare)

Ins. Median: $416 (117% 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
Mgb Health Plan [150001]	$265	74%
Harvard Pilgrim Alternate [120002]	$386	108%
Harvard Pilgrim [120001]	$386	108%
UnitedHealthcare	$386 - $1,651	108%
Tricare	$403	113%
Tufts Health Plan [170001]	$416	117%
Tufts Health Public Plans [1013]	$416	117%
Blue Cross Blue Shield	$424	119%
Fallon Health [1008]	$424	119%
Humana	$424	119%
Medicare (plans)	$424	119%
Molina [1014]	$424	119%
International Commercial [140001]	$831	233%
Aetna	$1,364	383%
Phcs Multiplan [1022]	$1,707	479%

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 $1,754.
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 Newton-Wellesley 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.