CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Nebraska Orthopaedic Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $522
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Nebraska Orthopaedic Hospital is $522. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.46x the Medicare baseline. Located in 2808 South 143Rd Plaza, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$522

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%)

Insurance Median: $522 (146%)

Ins. Median: $522 (146% 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.

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
Amerigroup	$80	22%
Aetna	$244 - $250	68%
Blue Cross Blue Shield	$348 - $2,739	98%
Humana	$348 - $3,475	98%
UnitedHealthcare	$348 - $3,884	98%
Paramount Group - Wellcare	$352	99%
Immanuel Pathways	$355	100%
Total Care	$442	124%
Allied	$452	127%
Ambetter / Centene	$522 - $776	146%
Carrum Health	$522 - $540	146%
Partners Health Alliance	$522	146%
Midlands Choice	$744 - $2,289	209%
Midwest Network	$2,289	642%
Self Pay	$2,657	745%
Multiplan	$3,679	1032%
Assist Health Imaging	$6,950	1950%

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 $X.
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 Nebraska Orthopaedic Hospital 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.