CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Essentia Health Moose Lake

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $2,006
  • Cash Discount Price: $2,528
  • vs. Medicare Baseline: 5.63x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Essentia Health Moose Lake is $2,006. 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 5.63x the Medicare baseline. Located in 4572 County Road 61, Moose Lake, MN.
Cash / Self-Pay
$2,528

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,006

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: $2,006 (563%)
Cash: $2,528 (709% of Medicare)
Ins. Median: $2,006 (563% 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 563% of the Medicare baseline (a markup of 463%). 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
Blue Cross Blue Shield $253 - $2,395 71%
Blue Plus Pmap Pcc Prime $253 - $1,882 71%
Itasca Med Care $357 100%
Primewest $371 104%
Medica Access $1,362 - $2,131 382%
Healthpartners Care Pmap $1,375 386%
Sanford Healthplan $1,467 - $1,545 412%
Advocare/Security Health $1,608 451%
Freedom Blue Ppo $1,608 451%
Healthpartners Care Msho / Mcr Adv $1,608 451%
Imcare Msho Pcc Prime $1,608 451%
Imcare Msho Ref Req $1,608 451%
Medica Advantage Solutions $1,608 451%
Medica Msho/Dual Solutions $1,608 451%
Medica Prime Solution Group $1,608 451%
Medicare (plans) $1,608 451%
Nd Va Administration $1,608 451%
Platinum Blue/Vantage Blue $1,608 451%
Primewest Msho $1,608 451%
Secure Blue Msho $1,608 451%
Ubh Cost Plan $1,608 451%
Ubh Msho $1,608 451%
Ucare Msho $1,608 451%
UnitedHealthcare $1,608 - $3,096 451%
Ucare $2,251 632%
Healthpartners $2,395 - $2,727 672%
Medica $2,446 - $2,720 686%
Medica Uplan $2,446 686%
Wea $2,463 - $2,634 691%
America'S Ppo $2,651 744%
Cigna $2,668 - $2,727 749%
Healthpartners Pcc Prime $2,668 - $2,727 749%
Medica Choice $2,802 786%
Wps $2,839 - $2,874 797%
Aetna $2,908 816%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4572 County Road 61, Moose Lake, MN 55767
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals