CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Worthington Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,353
Cash Discount Price: $4,128
vs. Medicare Baseline: 6.60x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Worthington Medical Center is $2,353. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,128. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.60x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$4,128

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,353

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: $4,128 (1158%)

Insurance Median: $2,353 (660%)

Cash: $4,128 (1158% of Medicare)

Ins. Median: $2,353 (660% 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 660% of the Medicare baseline (a markup of 560%). 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
Blue Cross Blue Shield	$283 - $2,322	79%
Sanford Health Plan Align	$333	93%
Ucare	$358 - $4,030	100%
Aetna	$361 - $4,231	101%
Health Partners	$361 - $3,663	101%
Medicare (plans)	$361	101%
UnitedHealthcare	$361 - $4,308	101%
Primewest	$368 - $393	103%
Sanford Health Plan	$2,000 - $2,353	561%
Security Health Plan	$2,838	796%
Medica	$4,602 - $4,927	1291%
First Choice Health Network	$4,644	1303%
Healthez	$4,644	1303%
Multiplan	$4,644	1303%

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 $4,128.
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 Sanford Worthington Medical Center 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.