CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Jennie M Melham Memorial Medical Center

Billing Code: 74177 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$1,130
about 3.2× the $356 Medicare rate · typically $329–$3,203
modeled estimate · not a bill or quote
Medicare pays $356 Fair price $1,130 Cash price $4,794 Hospital's list price $4,794

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

1 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $2,859 802%

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 145 Memorial Drive, Broken Bow, NE 68822
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals