CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Lexington Memorial Hospital Inc

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,637
Cash Discount Price: $2,961
vs. Medicare Baseline: 7.40x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Lexington Memorial Hospital Inc is $2,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,961. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.40x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$2,961

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,637

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: $2,961 (831%)

Insurance Median: $2,637 (740%)

Cash: $2,961 (831% of Medicare)

Ins. Median: $2,637 (740% 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 740% of the Medicare baseline (a markup of 640%). 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
Amerihealth	$1,116 - $1,627	313%
Carolina Complete	$1,116	313%
Healthy Blue	$1,116	313%
Partners	$1,116	313%
UnitedHealthcare	$1,127 - $2,653	316%
Vaya	$1,127	316%
Wellcare	$1,127	316%
Alliance	$1,138	319%
Trillium	$1,149	322%
Medcost	$1,297 - $3,962	364%
Blue Cross Blue Shield	$1,652 - $2,651	463%
Aetna	$1,682 - $5,472	472%
Ambetter / Centene	$1,700	477%
Oscar	$1,895 - $2,606	532%
Cigna	$2,576 - $2,623	723%
Directnet	$3,500	982%
Healthgram Lexington Home Brands	$4,264	1196%
Healthgram	$4,738	1329%
Private Healthcare Systems	$4,856	1362%
Beechstreet	$5,211	1462%
Humana	$5,211	1462%
Multiplan	$5,330	1495%
National Provider Network	$5,330	1495%

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 $2,961.
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 Lexington Memorial Hospital Inc 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.