CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,159
Cash Discount Price: $438
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Wellspan Ephrata Community Hospital is $1,159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $438. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.25x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.

Cash / Self-Pay

$438

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,159

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: $438 (123%)

Insurance Median: $1,159 (325%)

Cash: $438 (123% of Medicare)

Ins. Median: $1,159 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Medicaid / KanCare	$241 - $604	68%
Medicare (plans)	$348 - $635	98%
Aetna	$355 - $957	100%
Wellspan_Capital_Blue_Cross	$395	111%
Blue_Cross	$407 - $2,323	114%
Highmark	$535 - $1,582	150%
First_Health_Network	$1,052	295%
Cigna	$1,948 - $2,303	547%
United_Healthcare	$2,107	591%
Geisinger	$2,345	658%
Independence_Blue_Cross	$2,345	658%
Tower Health	$2,345 - $2,471	658%
Upmc	$2,345 - $2,886	658%
Phc	$2,526 - $2,562	709%

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 $438.
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 Wellspan Ephrata Community 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.