CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Medical City Lewisville

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,258
Cash Discount Price: $17,973
vs. Medicare Baseline: 3.53x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Medical City Lewisville is $1,258. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,973. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.53x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.

Cash / Self-Pay

$17,973

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,258

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: $17,973 (5043%)

Insurance Median: $1,258 (353%)

Cash: $17,973 (5043% of Medicare)

Ins. Median: $1,258 (353% 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 353% of the Medicare baseline (a markup of 253%). 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
Texas Health Network	$307	86%
Amerigroup	$312	88%
Cook Childrens Health Plan	$312	88%
Parkland Community Health Plan	$312	88%
United	$312 - $3,577	88%
Cigna	$328 - $2,516	92%
Aetna	$337 - $13,067	95%
Molina	$343 - $350	96%
Humana	$390 - $886	109%
Blue Cross Blue Shield	$481 - $7,980	135%
Superior Health Plan	$1,258	353%
Unicare	$4,314 - $17,973	1210%
Healthcare Highways	$6,075	1704%
City Of Mckinney	$8,088	2269%
Fidelis Securecare	$8,088	2269%
National Choicecare	$8,987	2521%
Pc Texas Partners	$9,885	2773%
Physicians Coop Of Tx	$9,885	2773%
Rockport Health Group	$9,885	2773%
Averde Health, Inc	$10,425	2925%
Usc Health Services	$10,784	3026%
Coastal Comp Health Networks	$12,581	3530%
Jostens	$12,581	3530%
Mega Life	$12,581	3530%
Healthsmart Preferred Care	$13,480	3782%
Lewisville Isd/Dls Consulting	$13,480	3782%
Usa Managed Care	$14,379	4034%
Galaxy Health Network	$15,277	4286%
Independent Medical Systems	$17,973	5043%
National Healthcare Solutions	$17,973	5043%

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 $17,973.
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 Medical City Lewisville 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.