CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Union Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $342
  • Cash Discount Price: $1,544
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Union Hospital is $342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,544. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.96x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$1,544

Average discount available for prompt cash payment at this facility.

Insurance Median
$342

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: $1,544 (433%)
Insurance Median: $342 (96%)
Cash: $1,544 (433% of Medicare)
Ins. Median: $342 (96% 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.

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
Summacare $53 - $2,211 15%
Aetna $82 - $3,158 23%
Blue Cross Blue Shield $82 - $1,265 23%
Cigna $82 - $1,069 23%
Humana $82 - $330 23%
The Health Plan $82 - $2,042 23%
United $82 - $1,173 23%
Valor $82 - $330 23%
Mmo $84 - $2,211 24%
Aultcare $86 - $1,069 24%
Communicare $86 - $346 24%
Perennial Health $88 - $356 25%
Pphp $88 - $363 25%
Zing Health $90 - $363 25%
Cc Ehp $92 - $1,772 26%
Buckeye $185 - $345 52%
Molina $185 - $362 52%
Caresource $194 - $345 54%
Amerihealth $204 - $379 57%
Oscar $209 - $913 59%
Ohcp $305 - $1,228 86%
Devoted Health $330 93%
UnitedHealthcare $330 - $333 93%
Upmc $330 - $1,895 93%
Omas $392 - $1,579 110%
Healthsmart $431 - $1,737 121%
Phphi $470 - $1,895 132%
Gms $548 - $2,211 154%
Consociate Health $587 - $2,368 165%
Multiplan $705 - $2,842 198%
Amish Community Aid Plan $1,069 - $1,188 300%
Ohio Healthy $1,282 360%
Php $1,425 400%
Medical Benefit Corp $1,662 466%
Frontpath $2,138 600%
Managed Care Services $2,138 600%
Tertiary Care Network $2,138 600%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals