CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Canby Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $4,086
  • Cash Discount Price: $4,086
  • vs. Medicare Baseline: 11.46x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Canby Medical Center is $4,086. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,086. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 11.46x the Medicare baseline. Located in 112 St Olaf Avenue South, Canby, MN.
Cash / Self-Pay
$4,086

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,086

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: $4,086 (1146%)
Insurance Median: $4,086 (1146%)
Cash: $4,086 (1146% of Medicare)
Ins. Median: $4,086 (1146% 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 1146% of the Medicare baseline (a markup of 1046%). 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 - $4,488 105%
Blue Cross Blue Shield $608 - $2,523 171%
Sanford Health Plan Align $2,329 653%
Aetna $2,523 - $4,439 708%
Health Partners $2,523 - $4,086 708%
Medicare (plans) $2,523 708%
UnitedHealthcare $2,523 - $4,265 708%
Primewest $2,574 - $2,809 722%
Security Health Plan $2,809 788%
Sanford Health Plan $4,032 - $4,744 1131%
Medica $4,490 - $4,832 1260%
Cigna $4,597 1290%
First Choice Health Network $4,597 1290%
Healthez $4,597 1290%
Multiplan $4,597 1290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 112 St Olaf Avenue South, Canby, MN 56220
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals