CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Avita Ontario

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $735
  • Cash Discount Price: $3,980
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Avita Ontario is $735. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,980. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.06x the Medicare baseline. Located in 715 Richland Mall, Ontario, OH.
Cash / Self-Pay
$3,980

Average discount available for prompt cash payment at this facility.

Insurance Median
$735

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: $3,980 (1117%)
Insurance Median: $735 (206%)
Cash: $3,980 (1117% of Medicare)
Ins. Median: $735 (206% 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 206% of the Medicare baseline (a markup of 106%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medical_Mutual $123 - $3,588 35%
Caresource $664 186%
Medicaid / KanCare $664 186%
Molina $664 - $5,629 186%
Ohiorise $664 186%
United_Healthcare $664 - $3,980 186%
Blue Cross Blue Shield $684 - $3,518 192%
Amerihealth $698 196%
Buckeye $719 - $3,518 202%
Humana $719 - $3,518 202%
Aetna $728 - $3,980 204%
Medicare (plans) $728 - $3,518 204%
Mount_Carmel $728 - $3,518 204%
Cigna $3,647 1023%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 715 Richland Mall, Ontario, OH 44906
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals