CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Novant Health Forsyth Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,575
Cash Discount Price: $2,469
vs. Medicare Baseline: 7.22x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Novant Health Forsyth Medical Center is $2,575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,469. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.22x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$2,469

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,575

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: $2,469 (693%)

Insurance Median: $2,575 (722%)

Cash: $2,469 (693% of Medicare)

Ins. Median: $2,575 (722% 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 722% of the Medicare baseline (a markup of 622%). 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	$290 - $3,448	81%
Humana	$338 - $3,910	95%
Pace Of The Southern Piedmont	$338	95%
UnitedHealthcare	$338 - $3,378	95%
Aetna	$347 - $4,015	97%
Cigna	$349 - $2,981	98%
Liberty Health	$355	100%
Nc Department Of Public Safety	$677 - $932	190%
Carolina Complete	$747 - $932	210%
Amerihealth	$762 - $951	214%
Wellcare	$762 - $951	214%
Caresource North Carolina	$1,610 - $2,008	452%
Atlantic Corporation Dba Atlantic Packaging	$2,274 - $2,836	638%
Plotkin Health	$2,414 - $3,011	677%
Amps	$2,616 - $3,262	734%
Medcost	$3,420 - $4,718	960%
Primary Physician Care	$3,541 - $4,417	993%
Beechstreet	$3,622 - $4,517	1016%
Multiplan	$3,622 - $4,517	1016%
Phcs	$3,622 - $4,517	1016%
Employers Choice Network	$3,903 - $4,868	1095%
Three Rivers Provider Network	$3,903 - $4,868	1095%

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 $2,469.
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 Novant Health Forsyth Medical Center 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.