CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Chippewa County Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,713
Cash Discount Price: $2,637
vs. Medicare Baseline: 4.81x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Chippewa County Hospital is $1,713. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,637. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.81x the Medicare baseline. Located in 824 North 11Th Street, Montevideo, MN.

Cash / Self-Pay

$2,637

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,713

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: $2,637 (740%)

Insurance Median: $1,713 (481%)

Cash: $2,637 (740% of Medicare)

Ins. Median: $1,713 (481% 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 481% of the Medicare baseline (a markup of 381%). 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	$788	221%
Health Partners Mcr	$1,663	467%
Medica Mcr Adv	$1,663	467%
Medica Mcr Cost/Select	$1,663	467%
Ucare Mcr Select	$1,663	467%
Ucare Mcr Adv	$1,713	481%
Ucare Msho	$1,713	481%
Ucare Non-Dual	$1,713	481%
Medica Mcaid	$1,874	526%
Ucare Ifp - All Other Plans	$1,913	537%
Medica Comm - All Other Plans	$3,538	993%
Health Partners Comm - All Other Plans	$3,619	1015%

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 $2,637.
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 Chippewa County 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.