CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Down East Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,391
Cash Discount Price: $2,023
vs. Medicare Baseline: 3.90x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Down East Community Hospital is $1,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,023. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.90x the Medicare baseline. Located in 11 Hospital Drive, Machias, ME.

Cash / Self-Pay

$2,023

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,391

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: $2,023 (568%)

Insurance Median: $1,391 (390%)

Cash: $2,023 (568% of Medicare)

Ins. Median: $1,391 (390% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 390% of the Medicare baseline (a markup of 290%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$379 - $3,657	106%
Humana	$379 - $1,994	106%
Wellcare	$379 - $1,994	106%
Partners Direct Health	$431 - $2,266	121%
Community Health Options	$713 - $3,752	200%
Aetna	$719 - $3,784	202%
UnitedHealthcare	$740 - $3,898	208%
Martins Point	$775 - $4,079	217%
Patients Advocates	$775 - $4,079	217%
Cigna	$777 - $4,088	218%
Harvard Pilgrim	$788 - $4,147	221%

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 $2,023.
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 Down East Community 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.