CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $130
Cash Discount Price: $2,690
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at The University of Vermont Health Network-Alice Hy is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,690. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.36x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$2,690

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $2,690 (755%)

Insurance Median: $130 (36%)

Cash: $2,690 (755% of Medicare)

Ins. Median: $130 (36% 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
Capital District Physicians' Health Plan	$55 - $4,953	15%
UnitedHealthcare	$57 - $5,194	16%
Blue Cross Blue Shield	$66 - $1,687	19%
Fidelis Care	$69 - $1,687	19%
Humana	$69 - $1,687	19%
Mvp	$69 - $1,687	19%
Martins Point	$81 - $1,687	23%
Aetna	$82 - $4,535	23%
Veterans Affairs Community Care Network	$82 - $1,687	23%
Choicecare	$85 - $3,955	24%
Magnacare	$86 - $4,218	24%
Highmark Blueshield	$105 - $4,725	29%
St. Regis	$195 - $1,687	55%

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 $2,690.
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 The University of Vermont Health Network-Alice Hy 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.