CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Samaritan Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $435
Cash Discount Price: $3,548
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Samaritan Medical Center is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,548. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.22x the Medicare baseline. Located in 830 Washington Street, Watertown, NY.

Cash / Self-Pay

$3,548

Average discount available for prompt cash payment at this facility.

Insurance Median

$435

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: $3,548 (995%)

Insurance Median: $435 (122%)

Cash: $3,548 (995% of Medicare)

Ins. Median: $435 (122% 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
Empire	$78 - $273	22%
Fidelis	$82 - $501	23%
Wellcare	$82 - $435	23%
Capital District Physician'S Health Plan, Inc (Cdphp)	$435 - $2,838	122%
Excellus	$435 - $1,999	122%
Aetna	$444 - $3,015	125%
UnitedHealthcare	$449 - $3,015	126%
Mvp	$457 - $2,696	128%
Ghi Emblem	$2,944	826%

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 $3,548.
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 Samaritan Medical Center 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.