CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Kaleida Health

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $243
  • Cash Discount Price: $988
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Kaleida Health is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $988. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.68x the Medicare baseline. Located in 100 High Street, Buffalo, NY.
Cash / Self-Pay
$988

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $988 (277%)
Insurance Median: $243 (68%)
Cash: $988 (277% of Medicare)
Ins. Median: $243 (68% 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.

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
Highmark Wny $41 - $104 12%
Emblemhealth - Hip $57 - $116 16%
Fidelis Care $66 - $171 19%
Univera Healthcare $67 - $142 19%
UnitedHealthcare $68 - $473 19%
Wellcare $70 - $453 20%
Molina Healthcare Of New York, Inc. $73 - $171 20%
Mvp Healthplan $76 21%
Humana $80 22%
American Progressive Life & Health $82 23%
Oxford Health Insurance Inc $91 26%
Meritain Health $104 - $130 29%
Ambetter / Centene $106 30%
Ghi/Emblem Health $243 - $588 68%
Ghi/Emblem Health - Wchob $243 - $304 68%
Aetna $253 - $462 71%
Independent Health Association $253 - $870 71%
Magnacare $253 - $324 71%
Magnacare - Wchob $253 - $324 71%
Independent Health Association - Wchob $263 - $870 74%
Univera $292 - $607 82%
Univera - Wchob $292 - $590 82%
Blue Cross Blue Shield $297 - $1,625 83%
Tricare $414 116%
Fidelis $470 132%
Cigna $510 - $618 143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 High Street, Buffalo, NY 14210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals