CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Ascension Saint Thomas Three Rivers

Billing Code: 74177 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$887
about 2.5× the $356 Medicare rate · typically $291–$2,080
modeled estimate · not a bill or quote
Medicare pays $356 Fair price $887 Cash price $944 Hospital's list price $3,148

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

0 of 6 major insurers have a published price at this hospital

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
No insurance-company prices are published for this procedure.
+ 1 smaller / regional plan $3,148

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 451 Highway 13 South, Waverly, TN 37185
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals