CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Holland Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $766
Cash Discount Price: $1,676
vs. Medicare Baseline: 2.15x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Holland Community Hospital is $766. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,676. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.15x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$1,676

Average discount available for prompt cash payment at this facility.

Insurance Median

$766

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: $1,676 (470%)

Insurance Median: $766 (215%)

Cash: $1,676 (470% of Medicare)

Ins. Median: $766 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Life Circles-All Plans	$330	93%
Health Alliance Mcr Adv	$348	98%
Ph Mcr Adv	$348	98%
Va Ccn - All Plans	$348	98%
Aetna	$358 - $401	100%
Longevity Health Plan-All Plans	$375	105%
Cofinity -All Plans	$534	150%
Blue Cross Blue Shield	$555	156%
Cigna	$691	194%
Sisco Epi	$759	213%
Sisco-All Other Plans	$759	213%
Priority Health - All Other Plans	$766	215%
Health Alliance Hmo	$788	221%
Asr - All Plans	$824	231%
Health Alliance Ahl - All Other Plans	$824	231%
Molina Mcaid - All Plans	$894	251%
Ph Mcaid	$894	251%
Multiplan - All Plans	$2,430	682%
Benefit Source Inc-All Plans	$2,514	705%
First Health-All Plans	$2,514	705%
Usa Managed Care-All Plans	$2,514	705%
Integrated Health Plans-All Plans	$2,653	744%
UnitedHealthcare	$2,793	784%
Nomi Health - All Plans	$5,726	1606%

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 $1,676.
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 Holland 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.