CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $297
Cash Discount Price: $3,066
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Munson Healthcare Otsego Memorial Hospital is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,066. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.83x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$3,066

Average discount available for prompt cash payment at this facility.

Insurance Median

$297

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: $3,066 (860%)

Insurance Median: $297 (83%)

Cash: $3,066 (860% of Medicare)

Ins. Median: $297 (83% 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
Mclaren Health Plan	$55 - $3,024	15%
Meridian	$55 - $182	15%
Molina	$55 - $375	15%
Priority Health	$55 - $794	15%
UnitedHealthcare	$55 - $2,889	15%
Blue Cross Blue Shield	$56 - $2,253	16%
Blue Care Network	$82 - $348	23%
Hap (Health Alliance Plan)	$82 - $2,886	23%
Humana	$82 - $348	23%
Medicare (plans)	$82 - $348	23%
Michigan Amish Medical Board	$82 - $348	23%
Northern Michigan Mennonite Group	$82 - $348	23%
Aetna	$83 - $2,922	23%
Asr Physicians Care Network	$124 - $2,886	35%
Cigna	$129 - $794	36%
Nomi Health	$132 - $2,886	37%
Employee Benefit Logistics	$140 - $591	39%
Munson Hospice	$852 - $2,525	239%
Hospice Of Michigan	$2,164	607%
Enterprise Group Planning/Employee Benefit Plan	$2,886	810%
Cofinity	$3,066	860%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$3,066	860%
Three Rivers Provider Network	$3,066	860%

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 $3,066.
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 Munson Healthcare Otsego Memorial 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.