CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: St Mary Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $463
Cash Discount Price: $3,059
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at St Mary Medical Center is $463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,059. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.30x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$3,059

Average discount available for prompt cash payment at this facility.

Insurance Median

$463

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: $3,059 (858%)

Insurance Median: $463 (130%)

Cash: $3,059 (858% of Medicare)

Ins. Median: $463 (130% 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
Medicaid / KanCare	$222 - $632	62%
Aetna	$279 - $3,959	78%
UnitedHealthcare	$316 - $2,153	89%
Blue Cross Blue Shield	$376	105%
Cigna	$380 - $1,701	107%
Align Senior Care	$384	108%
Medicare (plans)	$386 - $677	108%
Health America Advantra	$451	127%
Keystone First	$463 - $632	130%
Keystone First Chip	$463 - $632	130%
Pace-Trinity Health	$489	137%
Ambetter / Centene	$671	188%
Oscar	$677	190%
Prime Healthcare	$677	190%
Jefferson Health Plan Commercial	$685	192%
Homestead Health Plans Woods Center	$733	206%
Group Pension Administrators	$846	237%
Reedman Toll	$846	237%
Blue Shield - Pa (Highmark)	$1,017	285%
Upmc Health Plan	$1,701	477%
Webtpa	$1,701	477%
Geha	$1,815	509%
Meritain	$3,959	1111%
Multiplan	$4,003	1123%
Prime Health Services	$4,003	1123%
Galaxy Health Network	$4,226	1186%
Three Rivers Provider Network	$4,226	1186%

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 $3,059.
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 St Mary Medical Center 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.