CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Adena Fayette Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,563
Cash Discount Price: $2,016
vs. Medicare Baseline: 7.19x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Adena Fayette Medical Center is $2,563. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,016. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 7.19x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$2,016

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,563

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: $2,016 (566%)

Insurance Median: $2,563 (719%)

Cash: $2,016 (566% of Medicare)

Ins. Median: $2,563 (719% 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 719% of the Medicare baseline (a markup of 619%). 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
Aetna	$1,250 - $3,194	351%
First Health	$1,250 - $3,161	351%
Blue Cross Blue Shield	$1,371 - $2,674	385%
Buckeye Community Health Plan	$1,653	464%
Humana	$1,653	464%
Medical Mutual Of Ohio	$1,653 - $3,039	464%
Medigold	$1,653	464%
Molina	$1,653	464%
Care Source	$1,686	473%
Molina Marketplace	$1,819	510%
United Medical Resources Ohcp	$2,536	712%
UnitedHealthcare	$2,536 - $2,561	712%
Cigna	$2,778	779%
Ohio Ppo Connect	$2,823	792%
The Health Plan	$2,823	792%
Care Source Just4Me	$2,976	835%
Medical Mutual Of Ohio Supermed	$3,039	853%
Ohio Health Choice	$3,210	901%
Multiplan/Private Healthcare Systems	$3,831	1075%
Sidecar Health	$4,557	1279%

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 $2,016.
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 Adena Fayette 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.