CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Prisma Health Tuomey Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $817
  • Cash Discount Price: $3,397
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Prisma Health Tuomey Hospital is $817. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,397. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.29x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$3,397

Average discount available for prompt cash payment at this facility.

Insurance Median
$817

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: $3,397 (953%)
Insurance Median: $817 (229%)
Cash: $3,397 (953% of Medicare)
Ins. Median: $817 (229% 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 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $326 - $3,036 91%
Cigna $326 - $2,258 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $326 91%
Humana $326 - $3,920 91%
Medicare (plans) $326 - $342 91%
Triwest Healthcare Alliance Vcp [902] $326 91%
Va Community Care Network-Vaccn [903] $326 91%
Tricare $334 94%
UnitedHealthcare $337 - $829 95%
Aetna $342 - $4,129 96%
Healthy Conn Prime-First Choice Vip Care [5300] $342 96%
Healthy Conn Prime-Molina Healthcare [5330] $342 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $342 96%
Medicaid / KanCare $358 - $805 100%
Workers Comp [600] $456 128%
Ambetter / Centene $600 168%
Bluechoice [810] $778 - $3,035 218%
Golden Rule Insurance Company [2991] $829 233%
Oxford Health Plans [2992] $829 233%
Zzumr-Salt Lake City Ut [3169] $829 233%
Scdc-Sc Dept Of Corrections [7232] $873 245%
Prisma Health Seniorcare Pace - Midlands [5400] $1,212 340%
Prisma Health Seniorcare Pace-Upstate [5200] $1,212 340%
Promise Health Plan Contracted [2401] $1,829 - $1,875 513%
Bob Jones Univ-Pai [821] $1,840 516%
Orangeburg Senior Helping Center Pace [5401] $2,090 586%
Planned Administrators [820] $3,036 852%
Meritain Health Contracted [2200] $3,345 - $4,129 938%
Preferred Administrators Contracted [2839] $3,658 1026%
Medcost [2940] $3,867 - $4,338 1085%
Atlantic Packaging Contracted [4833] $3,920 1100%
Aps Healthcare System [2981] $4,181 1173%
Multiplan/Phcs Contracted [2950] $4,651 1305%
Vsp Vision Care [2986] $4,703 1319%
First Health Contracted [2952] $4,860 1364%
Furman Int/Allen University Student [2951] $4,860 1364%
Quiktrip-First Health [3067] $4,860 1364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals