CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Arbuckle Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $2,197
Cash Discount Price: $2,267
vs. Medicare Baseline: 6.16x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Arbuckle Memorial Hospital is $2,197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,267. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.16x the Medicare baseline. Located in 2011 West Broadway, Sulphur, OK.

Cash / Self-Pay

$2,267

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,197

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: $2,267 (636%)

Insurance Median: $2,197 (616%)

Cash: $2,267 (636% of Medicare)

Ins. Median: $2,197 (616% 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 616% of the Medicare baseline (a markup of 516%). 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
Blue Cross Blue Shield	$476	134%
Medica	$1,542	433%
Aetna	$2,126	596%
Multiplan	$2,267	636%
Ok Health Network	$2,551	716%
Health Choice Network	$2,834	795%

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 $2,267.
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 Arbuckle Memorial Hospital 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.