CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Ascension St John Sapulpa

Billing Code: 74177 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$656

about 1.8× the $356 Medicare rate · typically $256–$1,796

modeled estimate · not a bill or quote

What this hospital charges insurers

$575

Below the fair price — a good deal

about $81 under the fair price · 1.6× Medicare

Medicare pays $356 Fair price $656 This hospital $575 Cash price $1,188 Hospital's list price $3,210

How we calculate the fair BaseRate →

How this hospital compares to other OK hospitals

Highest price of the 9 OK hospitals we have prices for — worth calling around.

Cheapest $178 Priciest $575

Black dot = this hospital, among the 9 OK hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $656 (about 1.8× the $356 Medicare rate). Ascension St John Sapulpa charges insurers about $575, or about $1,188 in cash — below the fair price — a good deal. Located in Sapulpa, OK.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$575 - $616	161%
Aetnamajor	$222	62%

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,188), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 74177.

Insurance Before you use insurance

Call your insurance company to confirm Ascension St John Sapulpa is in-network.
Ask your insurer whether prior approval is required for CPT code 74177.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Ascension St John Sapulpa

Compare: CT scan, abdomen and pelvis (with contrast) at other OK hospitals

Insurance negotiated median for the same procedure, sorted lowest first.