CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $5,861
  • Cash Discount Price: $5,861
  • vs. Medicare Baseline: 16.44x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Atlantic Rehabilitation Institute, LLC is $5,861. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,861. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 16.44x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$5,861

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,861

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: $5,861 (1644%)
Insurance Median: $5,861 (1644%)
Cash: $5,861 (1644% of Medicare)
Ins. Median: $5,861 (1644% 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 1644% of the Medicare baseline (a markup of 1544%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $5,861 1644%
All Savers Cpd $5,861 1644%
Ama Insurance Msg $5,861 1644%
Ambetter / Centene $5,861 1644%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $5,861 1644%
Amerihealth Cpd $5,861 1644%
Amerihealth Mgg $5,861 1644%
Blue Cross Blue Shield $5,861 1644%
Braven Health Cpd $5,861 1644%
Braven Health Mgd $5,861 1644%
Cigna $5,861 1644%
Claim Doc Llc Cpd $5,861 1644%
First Managed Care Wc Cpd $5,861 1644%
Gateway Mgg $5,861 1644%
Medicaid / KanCare $5,861 1644%
Oscar Health Cpd $5,861 1644%
Oxford Health Plan Cpd $5,861 1644%
Oxford Mgg $5,861 1644%
Qualcare Cpd $5,861 1644%
Qualcare Lynx Wc Cpd $5,861 1644%
UnitedHealthcare $5,861 1644%
Upmc For Life Mgg $5,861 1644%
Wellcare Mgg $5,861 1644%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL