CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Charlevoix Area Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $376
Cash Discount Price: $2,205
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Charlevoix Area Hospital is $376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,205. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.05x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$2,205

Average discount available for prompt cash payment at this facility.

Insurance Median

$376

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: $2,205 (619%)

Insurance Median: $376 (105%)

Cash: $2,205 (619% of Medicare)

Ins. Median: $376 (105% 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 - $2,415	15%
Meridian	$55 - $246	15%
Priority Health	$55 - $2,594	15%
UnitedHealthcare	$55 - $2,254	15%
Blue Cross Blue Shield	$56 - $2,396	16%
Aetna	$82 - $2,342	23%
Blue Care Network	$82 - $1,219	23%
Hap (Health Alliance Plan)	$82 - $2,075	23%
Medicare (plans)	$82 - $1,219	23%
Michigan Amish Medical Board	$82 - $1,219	23%
Molina	$82 - $1,317	23%
Northern Michigan Mennonite Group	$82 - $1,219	23%
Asr Physicians Care Network	$124 - $2,075	35%
Cigna	$129 - $2,594	36%
Nomi Health	$132 - $2,412	37%
Employee Benefits Logistics	$140 - $2,073	39%
Provider Network Of America/Hma Group Health	$489 - $2,205	137%
Hospice Of Michigan	$1,556	437%
Enterprise Group Planning Employee Benefit Plan	$2,075	582%
First Health/Coventry Health/Community Care Network	$2,075	582%
Medical Cost Savings Solution	$2,075	582%
Three Rivers Provider Network	$2,205	619%
Iba Health And Life Assurance Company	$2,386	669%
Cofinity	$2,412	677%
Preferred Medical Claim Solutions	$2,464	691%

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 $2,205.
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 Charlevoix Area 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.