CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Southwest General Health Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,224
Cash Discount Price: $2,507
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Southwest General Health Center is $1,224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,507. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.43x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$2,507

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,224

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: $2,507 (703%)

Insurance Median: $1,224 (343%)

Cash: $2,507 (703% of Medicare)

Ins. Median: $1,224 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Medical Mutual	$142 - $160	40%
Medical Mutual-Ohio	$142 - $403	40%
Buckeye	$185 - $447	52%
Caresource	$185 - $365	52%
Humana	$185 - $1,317	52%
Molina	$185 - $447	52%
UnitedHealthcare	$185 - $1,824	52%
Amerihealth Caritas	$193 - $365	54%
Blue Cross Blue Shield	$365 - $537	102%
Valor Health	$403	113%
Healthsmart	$1,059 - $1,081	297%
Health Design Plus	$1,224 - $1,249	343%
Clarity Health	$1,324 - $1,351	371%
Healthspan	$1,324 - $1,351	371%
Healthsmart Preferred	$1,489 - $1,520	418%
Ohio Health Choice Plus	$1,602 - $1,634	449%
Summacare	$1,787 - $1,824	501%
Aetna	$1,790 - $1,827	502%
Cigna	$1,810 - $1,847	508%
Coventry	$2,283 - $2,330	641%
First Health	$2,283 - $2,330	641%
Ohio Health Choice	$2,558 - $2,610	718%
Private Healthare Systems	$2,647 - $2,702	743%

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 $2,507.
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 Southwest General Health 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.