CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: North Memorial Health Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $639
Cash Discount Price: $707
vs. Medicare Baseline: 1.79x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at North Memorial Health Hospital is $639. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $707. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.79x the Medicare baseline. Located in 3300 Oakdale North, Robbinsdale, MN.

Cash / Self-Pay

$707

Average discount available for prompt cash payment at this facility.

Insurance Median

$639

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: $707 (198%)

Insurance Median: $639 (179%)

Cash: $707 (198% of Medicare)

Ins. Median: $639 (179% 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
Health Partners [1061]	$282 - $962	79%
Blue Cross Blue Shield	$300 - $742	84%
Medicaid / KanCare	$344	97%
Humana	$361	101%
Medicare (plans)	$361	101%
Ucare [1148]	$361 - $661	101%
Medica [1086]	$365 - $1,432	102%
UnitedHealthcare	$376 - $881	105%
Aetna	$392	110%
America'S Ppo [1010]	$908 - $966	255%
Cigna	$945	265%
Phcs [1172]	$1,006	282%
Multiplan [1176]	$1,073	301%

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 $707.
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 North Memorial Health 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.