CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Thomas Jefferson University Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $371
Cash Discount Price: $412
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Thomas Jefferson University Hospital is $371. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $412. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.04x the Medicare baseline. Located in 111 South 11Th Street, Philadelphia, PA.

Cash / Self-Pay

$412

Average discount available for prompt cash payment at this facility.

Insurance Median

$371

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: $412 (116%)

Insurance Median: $371 (104%)

Cash: $412 (116% of Medicare)

Ins. Median: $371 (104% 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
Pa Health_Wellness Chc	$251 - $342	70%
Medicaid / KanCare	$261 - $356	73%
Jefferson Health Plan Aca Qhp Exchange	$306	86%
Innovage	$323	91%
Inspira Life	$323	91%
Keystone First Vip Choice	$323 - $329	91%
Medicare (plans)	$323 - $371	91%
Point Of Comfort Refugee Resettlement	$323	91%
St Agnes	$323	91%
Tricare	$323	91%
UnitedHealthcare	$323 - $1,288	91%
Humana	$329	92%
Cigna	$335 - $809	94%
Devoted Health Participation	$339	95%
Aetna	$342 - $1,661	96%
Provider Partners Health Plan	$345	97%
Allwell Pa Health_Wellness Ma	$355	100%
Perennial	$374	105%
Highmark Wholecare Gateway	$377	106%
Ibc Employee Benefit	$403	113%
Ibc Main Line Health	$403	113%
Ambetter / Centene	$468	131%
Naphcare	$516 - $613	145%
Keystone First	$538 - $734	151%
Ibc	$646 - $1,021	181%
Upmc Commercial	$809	227%
Geisinger Health Plan	$1,314	369%
Blue Cross Blue Shield	$2,103	590%

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 $412.
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 Thomas Jefferson University 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.