CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Glens Falls Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $602
Cash Discount Price: $659
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Glens Falls Hospital is $602. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $659. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.69x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$659

Average discount available for prompt cash payment at this facility.

Insurance Median

$602

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: $659 (185%)

Insurance Median: $602 (169%)

Cash: $659 (185% of Medicare)

Ins. Median: $602 (169% 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
Aetna	$91 - $909	26%
Mvp Commercial	$163 - $570	46%
Blue Shield	$258 - $860	72%
Cdphp	$339 - $993	95%
Blue Cross Blue Shield	$403 - $857	113%
Mvp	$441 - $927	124%
Fidelis	$485 - $993	136%
Hamaspik	$857	240%
Nascentia Health Options	$857	240%
Magnacare	$988	277%
Emblem	$1,054	296%
Empire Plan Nyship	$1,120	314%
Multiplan	$1,120	314%
UnitedHealthcare	$1,120	314%

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 $659.
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 Glens Falls 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.