CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $350
Cash Discount Price: $1,784
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Ascension Providence Hospital, Southfield and Novi is $350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,784. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.98x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$1,784

Average discount available for prompt cash payment at this facility.

Insurance Median

$350

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: $1,784 (501%)

Insurance Median: $350 (98%)

Cash: $1,784 (501% of Medicare)

Ins. Median: $350 (98% 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
Medicaid / KanCare	$183 - $350	51%
Molina Health	$183 - $203	51%
Blue Caid Michigan	$203	57%
Harbor Health Mcd	$203	57%
Total Health Care	$203	57%
UnitedHealthcare	$203	57%
Priority Ppo	$221	62%
Hap Alliance Health	$241	68%
Hap Hmo Pos	$241	68%
Priority Health Hmo	$258	72%
Hap Preferred	$284	80%
Amerihealth Vip Care Mcr	$301 - $346	84%
Bc Metro Detroit Epo	$328 - $483	92%
Aetna	$350 - $722	98%
Auto Insurance	$350	98%
Jvhl - Mcr Replacement	$350	98%
Mcr Replacement	$350	98%
Veterans Choice	$350	98%
Humana	$353	99%
Meridian Wellcare	$367	103%
Molina Advantage	$367	103%
Bc Metro Detroit Hmo	$369 - $483	104%
Bcn Local Network Southeast	$369 - $483	104%
Ambetter / Centene	$437	123%
Molina Marketplace	$437	123%
Blue Care Network	$477 - $483	134%
Blue Cross Blue Shield	$477 - $483	134%
Smart Health	$483	136%

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 $1,784.
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 Ascension Providence Hospital, Southfield and Novi 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.