CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Bertrand Chaffee Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $215
  • Cash Discount Price: $242
  • vs. Medicare Baseline: 0.60x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Bertrand Chaffee Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $242. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.60x the Medicare baseline. Located in 224 East Main Street, Springville, NY.
Cash / Self-Pay
$242

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $242 (68%)
Insurance Median: $215 (60%)
Cash: $242 (68% of Medicare)
Ins. Median: $215 (60% 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
Comm Blue Essential $65 18%
Community Blue $65 18%
Community Care - Bc $65 18%
Fidelis Care Of New York $65 18%
Ghi Medical $65 18%
Gowanda Correctional Fac $65 18%
Medicaid / KanCare $65 18%
Molina Essential Plan $65 18%
Molina Heathcare Of Wny $65 18%
Seneca Nation Health Dept $65 18%
United Hc - Community Pln $65 18%
United Hc Essential Plan $65 18%
Univera Hc Myhealth $65 18%
Univera Hc Myhealth+ $65 - $263 18%
Yourcare $65 18%
Private Pay $102 - $382 29%
Aetna $120 - $450 34%
American Progressive Ins. $120 - $450 34%
Cigna $120 - $450 34%
Commercial / Misc $120 - $450 34%
Global Excel Mgt $120 - $450 34%
Guardian Life Ins. Co. $120 - $450 34%
Mvp Commercial $120 - $450 34%
No Amer Meritian Health $120 - $450 34%
No-Fault $120 - $450 34%
Iha Essential Plans $215 - $283 60%
Iha Medisource $215 - $283 60%
Blue Cross Blue Shield $222 - $244 62%
Senior Blue - Bc $222 62%
Fidelis Essential Plans $245 69%
Univera Essential Plans $263 74%
Univera Hc Child Health+ $263 74%
Univera Plus Med $263 74%
Iha Encompass 65 $298 84%
Univera Senior Choice $309 87%
Univera Healthcare $371 104%
Iha $453 127%
Iha Custom Coverage $453 127%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 224 East Main Street, Springville, NY 14141
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals