CMS Price Transparency Data
CT scan, abdomen and pelvis (with contrast)
Facility: St Charles Hospital
Billing Code: 74177 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 74177
- Insurance Median: $423
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St Charles Hospital is $423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.19x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$423
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%)
Insurance Median: $423 (119%)
Ins. Median: $423 (119% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $109 - $245 | 31% |
| Beacon Health Options | $109 - $592 | 31% |
| Beacon Health Strategies | $109 - $592 | 31% |
| Centerlight Healthcare | $109 - $423 | 31% |
| Elderplan Inc. | $109 - $423 | 31% |
| Emblem Health | $109 - $951 | 31% |
| Fidelis Care New York | $109 - $423 | 31% |
| Health First | $109 - $951 | 31% |
| Health Plus | $109 - $423 | 31% |
| Independent Health | $109 - $423 | 31% |
| Medicaid / KanCare | $109 | 31% |
| Mvp Health Plans | $109 - $1,365 | 31% |
| Senior Whole Health | $109 - $423 | 31% |
| UnitedHealthcare | $109 - $828 | 31% |
| Blue Cross Blue Shield | $414 - $808 | 116% |
| Aetna | $423 - $2,331 | 119% |
| Centers Plan For Healthy Living | $423 | 119% |
| Healthspring | $423 | 119% |
| Liberty Health | $423 | 119% |
| Longevity Health Plan | $423 | 119% |
| Medicare (plans) | $423 - $444 | 119% |
| Orthonet - Uniformed Services Family Health Plan | $423 | 119% |
| Pmc | $423 | 119% |
| Tricare | $423 | 119% |
| Universal Healthcare | $423 | 119% |
| Us Family Health Plan | $423 | 119% |
| Veterans Affairs | $423 | 119% |
| Humana | $431 | 121% |
| Agewell New York | $437 | 123% |
| Partners Health Plan | $444 | 125% |
| Wellcare Health Plan Inc | $465 | 130% |
| Brighton | $598 - $2,678 | 168% |
| Zadroga | $598 | 168% |
| Self Pay | $808 | 227% |
| Surest | $828 | 232% |
| American Plan Administrators | $951 | 267% |
| Amerihealth Administrators | $951 | 267% |
| Benefit Services | $951 | 267% |
| Ghi Cbp Ny City Employee Alternate | $951 | 267% |
| International Benefit Administrator | $951 | 267% |
| Ultra Benefits Inc. | $951 | 267% |
| Local 1199 | $1,272 | 357% |
| Apwu | $1,365 | 383% |
| Centivo | $1,365 - $1,835 | 383% |
| Cigna | $1,365 - $2,486 | 383% |
| Daniel H Cook | $1,365 | 383% |
| Nalc | $1,365 | 383% |
| Samba | $1,365 | 383% |
| Oscar Health | $1,568 | 440% |
| Mail Handlers Benefit Plan | $2,331 | 654% |
| Meritain Health | $2,331 | 654% |
| Nippon Life Insurance Company Of America | $2,331 | 654% |
| Salvation Army | $2,331 | 654% |
| Allied Wellfare Fund | $2,486 | 697% |
| American Group Administrators | $2,486 | 697% |
| Bakery & Confectionery Union | $2,486 | 697% |
| Comprehensive Benefits Consultant | $2,486 | 697% |
| Guardian Life Insurance Company Of America | $2,486 | 697% |
| Maloney And Assoc | $2,486 | 697% |
| Multiplan | $2,486 | 697% |
| Performax | $2,486 | 697% |
| Phcs | $2,486 | 697% |
| Pomco | $2,486 | 697% |
| Tpa Inc | $2,486 | 697% |
| Unicare | $2,486 | 697% |
| United Employees Health Plan | $2,486 | 697% |
| Coventry | $2,830 - $3,251 | 794% |
| Magellan | $3,060 | 859% |
| Galaxy | $3,442 | 966% |
| Three Rivers Provider Network | $3,442 | 966% |
| Aither Health | $3,825 | 1073% |
| Alpha Care | $3,825 | 1073% |
| Dentaquest | $3,825 | 1073% |