CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: St John Owasso

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $350
Cash Discount Price: $1,188
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St John Owasso is $350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,188. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.98x the Medicare baseline. Located in 12451 East 100Th Street North, Owasso, OK.

Cash / Self-Pay

$1,188

Average discount available for prompt cash payment at this facility.

Insurance Median

$350

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: $1,188 (333%)

Insurance Median: $350 (98%)

Cash: $1,188 (333% of Medicare)

Ins. Median: $350 (98% 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.

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	$222	62%
Champva	$340	95%
Community Care - St John Network Senior - Govt	$340	95%
Communitycare Senior	$340	95%
Life Pace	$340	95%
Longevity Health Plan Of Oklahoma	$340	95%
Medicare (plans)	$340	95%
UnitedHealthcare	$340 - $350	95%
Va Community Care Network	$340	95%
Veterans Administration	$340	95%
Humana	$343	96%
Blue Cross Blue Shield	$357 - $714	100%
Communitycare (Standard)	$374	105%
Community Care (Select) 7/1/13	$408	114%
Ccl&H	$442	124%
Smarthealth	$476	134%
Community Care Smarthealth	$510 - $815	143%
Communitycare (Select)	$510 - $781	143%
Connect Health Benefit	$679	191%
Evolutions	$679	191%
Kempton Group Administrators	$764	214%

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 $1,188.
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 St John Owasso 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.