CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Tristar Summit Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,210
Cash Discount Price: $17,166
vs. Medicare Baseline: 3.39x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Tristar Summit Medical Center is $1,210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,166. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.39x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$17,166

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,210

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: $17,166 (4816%)

Insurance Median: $1,210 (339%)

Cash: $17,166 (4816% of Medicare)

Ins. Median: $1,210 (339% 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 339% of the Medicare baseline (a markup of 239%). 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
Blue Cross Blue Shield	$276 - $513	77%
Humana	$340 - $11,158	95%
United	$341 - $7,724	96%
Aetna	$459 - $8,583	129%
Kentucky Labor Cabinet	$3,160	887%
Apex Health	$3,261	915%
Nhc Advantage, Inc.	$3,261	915%
Pruitt Health (Allyalign)	$3,261	915%
Cigna	$5,596 - $13,732	1570%
Bgfh Singlesource	$8,583 - $14,591	2408%
Multiplan	$11,158	3130%
Employers Health Network	$12,016	3371%
Compsych	$13,732	3853%
Beech Street	$15,106	4238%
Prime Health	$15,106	4238%

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 $17,166.
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 Tristar Summit 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.