CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Bagley Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,192
  • Cash Discount Price: $4,016
  • vs. Medicare Baseline: 11.76x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Bagley Medical Center is $4,192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,016. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.76x the Medicare baseline. Located in 203 4Th Street Northwest, Bagley, MN.
Cash / Self-Pay
$4,016

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,192

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: $4,016 (1127%)
Insurance Median: $4,192 (1176%)
Cash: $4,016 (1127% of Medicare)
Ins. Median: $4,192 (1176% 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 1176% of the Medicare baseline (a markup of 1076%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Ucare $375 - $4,411 105%
Blue Cross Blue Shield $608 - $2,480 171%
Sanford Health Plan Align $2,289 642%
Health Partners $2,480 - $4,066 696%
Medicare (plans) $2,480 696%
UnitedHealthcare $2,480 - $4,192 696%
Primewest $2,530 - $2,706 710%
Aetna $2,691 - $4,362 755%
Security Health Plan $2,761 775%
Sanford Health Plan $3,963 - $4,662 1112%
Medica $4,413 - $4,749 1238%
Cigna $4,518 1268%
First Choice Health Network $4,518 1268%
Healthez $4,518 1268%
Multiplan $4,518 1268%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 203 4Th Street Northwest, Bagley, MN 56621
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals