CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Novant Health Ballantyne Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,173
Cash Discount Price: $2,820
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Novant Health Ballantyne Medical Center is $1,173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,820. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.29x the Medicare baseline. Located in 10905 Providence Road W, Charlotte, NC.

Cash / Self-Pay

$2,820

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,173

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: $2,820 (791%)

Insurance Median: $1,173 (329%)

Cash: $2,820 (791% of Medicare)

Ins. Median: $1,173 (329% 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 329% of the Medicare baseline (a markup of 229%). 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 - $3,328	81%
Humana	$339 - $4,061	95%
Pace Of The Southern Piedmont	$339	95%
UnitedHealthcare	$339 - $3,294	95%
Aetna	$348 - $4,512	98%
Cigna	$349 - $2,905	98%
Liberty Health	$356	100%
Nc Department Of Public Safety	$678 - $1,150	190%
Carolina Complete	$1,150	323%
Amerihealth	$1,173	329%
Wellcare	$1,173	329%
Caresource North Carolina	$1,861	522%
Atlantic Corporation Dba Atlantic Packaging	$2,594	728%
Amps	$3,102	870%
Plotkin Health	$3,384	949%
Medcost	$4,004 - $4,230	1123%
Primary Physician Care	$4,174	1171%
Multiplan	$4,230	1187%
Phcs	$4,230	1187%
Employers Choice Network	$5,471	1535%
Three Rivers Provider Network	$5,471	1535%

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 $2,820.
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 Ballantyne 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.