CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Kenmore Mercy Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $307
Cash Discount Price: $298
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Kenmore Mercy Hospital is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.86x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.

Cash / Self-Pay

$298

Average discount available for prompt cash payment at this facility.

Insurance Median

$307

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: $298 (84%)

Insurance Median: $307 (86%)

Cash: $298 (84% of Medicare)

Ins. Median: $307 (86% 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
UnitedHealthcare	$67 - $312	19%
Univera Healthcare Essential [100170]	$78 - $263	22%
Fidelis Essential [100163]	$147 - $327	41%
Blue Cross Blue Shield	$147 - $446	41%
Molina Essential [100167]	$147 - $464	41%
Amerigroup [350102]	$194 - $446	54%
Tuscarora Nation [550120]	$206	58%
Crime Victims [100176]	$206	58%
Excellus Rochester McD [350117]	$206	58%
Independent Health Essential [100166]	$206 - $450	58%
Vna Option Mltc [350110]	$206	58%
Medicaid / KanCare	$206 - $375	58%
Hospice [550001]	$214 - $297	60%
Medicare (plans)	$219 - $544	61%
VA Veterans Affairs [700001]	$253	71%
Univera Healthcare [100169]	$263 - $371	74%
Beacon Essential [350122]	$268 - $357	75%
Ghi [100153]	$282	79%
Fallon Health [450115]	$297	83%
Cigna	$297 - $431	83%
Catholic Health Life Pace [400005]	$297	83%
Seneca Nation [450119]	$297	83%
Tricare	$297	83%
Covid19 Hrsa [45013]	$297	83%
Champ VA [700002]	$297	83%
Fidelis Dual Advantage [450120]	$312	88%
Wellcare Fidelis Dual [450451]	$312	88%
Aetna	$312	88%
Humana	$312	88%
Iha First Choice [800001]	$323 - $670	91%
Independent Health [100165]	$323 - $901	91%
Wellcare [450129]	$327	92%
Beacon Health Options [100023]	$357	100%
Fidelis Exchange [100164]	$357	100%
No Fault [114001]	$385 - $506	108%
Mvp Healthcare [100168]	$396	111%
Federal Workers Compensation [500100]	$506	142%
UPMC Health Plan [100181]	$535	150%

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 $298.
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 Kenmore Mercy 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.