CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Sanford Luverne Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $3,575
  • Cash Discount Price: $4,336
  • vs. Medicare Baseline: 10.03x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Sanford Luverne Medical Center is $3,575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,336. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 10.03x the Medicare baseline. Located in 1600 N Kniss Avenue P O Box 1019, Luverne, MN.
Cash / Self-Pay
$4,336

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,575

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: $4,336 (1217%)
Insurance Median: $3,575 (1003%)
Cash: $4,336 (1217% of Medicare)
Ins. Median: $3,575 (1003% 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 1003% of the Medicare baseline (a markup of 903%). 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 - $4,762 105%
Blue Cross Blue Shield $608 - $4,434 171%
Sanford Health Plan Align $1,908 535%
Aetna $2,065 - $4,710 579%
Health Partners $2,065 - $4,336 579%
Medicare (plans) $2,065 579%
UnitedHealthcare $2,065 - $4,526 579%
Primewest $2,106 - $2,564 591%
Sanford Health Plan $2,904 - $3,416 815%
Security Health Plan $2,981 836%
Medica $4,764 - $5,127 1337%
Cigna $4,878 1369%
First Choice Health Network $4,878 1369%
Healthez $4,878 1369%
Multiplan $4,878 1369%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N Kniss Avenue P O Box 1019, Luverne, MN 56156
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals