CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Fairfield Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,989
Cash Discount Price: $2,003
vs. Medicare Baseline: 5.58x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Fairfield Medical Center is $1,989. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,003. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.58x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$2,003

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,989

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: $2,003 (562%)

Insurance Median: $1,989 (558%)

Cash: $2,003 (562% of Medicare)

Ins. Median: $1,989 (558% 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 558% of the Medicare baseline (a markup of 458%). 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
Humana	$303 - $6,457	85%
Aetna	$331 - $5,996	93%
Blue Cross Blue Shield	$331 - $26,250	93%
Buckeye Community Health	$331 - $9,481	93%
Medical Mutual	$331 - $33,500	93%
Medicare (plans)	$331 - $5,996	93%
Medigold	$336 - $6,117	94%
Molina	$336 - $10,093	94%
UnitedHealthcare	$336 - $6,117	94%
Va Ccn	$336 - $6,117	94%
The Health Plan	$338 - $6,116	95%
Valor Health Plan	$338 - $6,116	95%
Caresource	$343 - $7,952	96%
Medicaid / KanCare	$365	102%
Amerihealth Caritas Ohio	$383	107%
Oscar	$437 - $6,403	123%
Bwc	$467 - $8,497	131%
Allied Benefit Systems	$1,463 - $4,724	410%
Meritain Health	$1,463 - $4,724	410%
Quality Care Partners/Ohio Ppo Connect	$1,516 - $4,894	425%
The Ohio State Health Plan	$1,621 - $5,234	455%
Cigna	$1,735 - $5,601	487%
Ohio Healthy	$1,979 - $6,389	555%
Multiplan	$2,000 - $6,457	561%
Miscellaneous Plans	$2,105 - $6,797	591%

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 $2,003.
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 Fairfield Medical Center 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.