CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Hospital for Special Surgery

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $771
Cash Discount Price: $1,490
vs. Medicare Baseline: 2.16x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Hospital for Special Surgery is $771. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,490. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.16x the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$1,490

Average discount available for prompt cash payment at this facility.

Insurance Median

$771

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: $1,490 (418%)

Insurance Median: $771 (216%)

Cash: $1,490 (418% of Medicare)

Ins. Median: $771 (216% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$65 - $1,183	18%
Fidelis	$68 - $72	19%
Metro Plus	$91 - $95	26%
Aetna	$93 - $220	26%
Affinity By Molina Health Plan [1005]	$93 - $1,124	26%
Blue Cross Blue Shield	$93 - $2,289	26%
Christian Brothers [1034]	$93	26%
Connecticare [1039]	$93 - $2,289	26%
Emblem	$93 - $123	26%
Emblem Health [1043]	$93 - $2,289	26%
Harvard Pilgrim [1057]	$93 - $1,183	26%
Medicare (plans)	$93	26%
Meritain Health [1085]	$93	26%
Nippon Life [1092]	$93	26%
Oxford [1096]	$93 - $823	26%
Student Resources [1103]	$93 - $1,030	26%
Webtpa [1356]	$93	26%
Nyship	$139	39%
Cigna	$191 - $1,950	54%
Horizon	$225	63%
Fidelis Essential [1323]	$245	69%
Apwu [1016]	$771 - $1,950	216%
Nalc [1090]	$771 - $1,950	216%
Qualcare [1101]	$771 - $1,950	216%
Wellfleet [1361]	$771 - $1,950	216%
Geha [1053]	$1,030	289%

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 $1,490.
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 Hospital for Special Surgery 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.