CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Shriners Hospital for Children - Portland

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $450
Cash Discount Price: $3,567
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Shriners Hospital for Children - Portland is $450. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,567. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.26x the Medicare baseline. Located in 3101 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$3,567

Average discount available for prompt cash payment at this facility.

Insurance Median

$450

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: $3,567 (1001%)

Insurance Median: $450 (126%)

Cash: $3,567 (1001% of Medicare)

Ins. Median: $450 (126% 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
Cigna	$306	86%
Moda Eastern Oregon	$309	87%
Aetna	$336	94%
UnitedHealthcare	$382	107%
Ambetter / Centene	$439	123%
Providence Health Plan	$460	129%
Sana Benefits	$540	152%
Pacific Source Health Plans	$637	179%
Blue Cross Blue Shield	$1,200	337%
Moda	$1,351	379%

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 $3,567.
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 Shriners Hospital for Children - Portland 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.