CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Bella Vista Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $250
  • Cash Discount Price: $475
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Bella Vista Hospital is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.70x the Medicare baseline. Located in Carr 349 Km 2 7 Cerro Las Mesas, Mayaguez, PR.
Cash / Self-Pay
$475

Average discount available for prompt cash payment at this facility.

Insurance Median
$250

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: $475 (133%)
Insurance Median: $250 (70%)
Cash: $475 (133% of Medicare)
Ins. Median: $250 (70% 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.

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
Acaa $138 39%
International Medical Card $162 45%
Plan Salud Menonita Vital $166 47%
Medicare (plans) $168 - $265 47%
First Medical Vital $176 49%
Mcs $190 53%
Mapfre Life Insurance Life Insurance $200 56%
Triple S $225 63%
Triple S Vital $235 66%
Preferred Medical Choice(Pmc) $265 74%
Triple S Advantage $279 78%
Champva $287 81%
Tricare $287 81%
UnitedHealthcare $287 81%
Plan Salud Menonita $300 84%
Asociacion Maestros (Prossam) $350 98%
Servicios De Salud Bella Vista $475 133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Carr 349 Km 2 7 Cerro Las Mesas, Mayaguez, PR 00681
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals