CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Saint Thomas Highlands Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $337
Cash Discount Price: $1,810
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Saint Thomas Highlands Hospital is $337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,810. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.95x the Medicare baseline. Located in 401 Sewell Dr, Sparta, TN.

Cash / Self-Pay

$1,810

Average discount available for prompt cash payment at this facility.

Insurance Median

$337

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: $1,810 (508%)

Insurance Median: $337 (95%)

Cash: $1,810 (508% of Medicare)

Ins. Median: $337 (95% 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
Blue Cross Blue Shield	$193 - $444	54%
Community Plan	$287	81%
Point Comfort Underwriters	$303	85%
Amerigroup Mcr Replacement	$337	95%
Ascension Complete	$337	95%
Centurion Of Tn	$337	95%
Covid Uninsured Test Fund	$337	95%
Healthspring Mcr Replacement	$337	95%
Humana	$337	95%
Medicare (plans)	$337	95%
Nhc Advantage	$337	95%
UnitedHealthcare	$337 - $611	95%
Aetna	$344 - $3,138	97%
Ambetter / Centene	$438	123%
Oscar Health	$472	132%
Smart Health	$472	132%
Cigna	$669 - $819	188%

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 $1,810.
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 Saint Thomas Highlands 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.