CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Essentia Health Ada

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,251
Cash Discount Price: $2,528
vs. Medicare Baseline: 6.32x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Essentia Health Ada is $2,251. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,528. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.32x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.

Cash / Self-Pay

$2,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,251

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: $2,528 (709%)

Insurance Median: $2,251 (632%)

Cash: $2,528 (709% of Medicare)

Ins. Median: $2,251 (632% 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 632% of the Medicare baseline (a markup of 532%). 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
Itasca Med Care	$357	100%
Primewest	$371	104%
Healthpartners Care Pmap	$1,331	373%
Medica Access	$1,362 - $2,131	382%
Sanford Health Plan	$1,467 - $1,545	412%
Advocare/Security Health	$1,642	461%
Blue Cross Blue Shield	$1,642 - $2,982	461%
Freedom Blue Ppo	$1,642	461%
Healthpartners Care Msho / Mcr Adv	$1,642	461%
Imcare Msho Pcc Prime	$1,642	461%
Imcare Msho Ref Req	$1,642	461%
Medica Advantage Solutions	$1,642	461%
Medica Msho/Dual Solutions	$1,642	461%
Medica Prime Solution Group	$1,642	461%
Medicare (plans)	$1,642	461%
Nd Va Administration	$1,642	461%
Platinum Blue/Vantage Blue	$1,642	461%
Primewest Msho	$1,642	461%
Secure Blue Msho	$1,642	461%
Ubh Cost Plan	$1,642	461%
Ubh Msho	$1,642	461%
Ucare Msho	$1,642	461%
UnitedHealthcare	$1,642 - $3,096	461%
Blue Plus Pmap Pcc Prime	$1,882 - $2,981	528%
Healthpartners	$2,080 - $2,275	584%
Ucare	$2,251	632%
Cigna	$2,275	638%
Healthpartners Pcc Prime	$2,275	638%
Wea	$2,463 - $2,634	691%
America'S Ppo	$2,651	744%
Wps	$2,839 - $2,874	797%
Medica	$2,843 - $2,993	798%
Medica Uplan	$2,843	798%
Aetna	$2,908	816%
Medica Choice	$3,082	865%

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 $2,528.
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 Essentia Health Ada 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.