CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: St Francis Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,532
Cash Discount Price: $7,290
vs. Medicare Baseline: 4.30x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St Francis Memorial Hospital is $1,532. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,290. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 4.30x the Medicare baseline. Located in 430 North Monitor St, West Point, NE.

Cash / Self-Pay

$7,290

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,532

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: $7,290 (2045%)

Insurance Median: $1,532 (430%)

Cash: $7,290 (2045% of Medicare)

Ins. Median: $1,532 (430% 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 430% of the Medicare baseline (a markup of 330%). 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	$92 - $6,926	26%
Humana	$92 - $3,208	26%
Medica	$92 - $6,998	26%
Nebraska Total Care	$94 - $3,273	26%
Aetna	$96 - $6,998	27%
Good Samaritan Insurance Plan Of Nebraska	$96 - $3,368	27%
Molina Healthcare Of Nebraska	$96 - $3,645	27%
UnitedHealthcare	$2,770 - $6,998	777%
Midlands Choice	$6,998	1963%

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 $7,290.
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 St Francis Memorial 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.