CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Memorial Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $1,108
  • Cash Discount Price: $1,854
  • vs. Medicare Baseline: 3.11x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Memorial Medical Center is $1,108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,854. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 3.11x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$1,854

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,108

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: $1,854 (520%)
Insurance Median: $1,108 (311%)
Cash: $1,854 (520% of Medicare)
Ins. Median: $1,108 (311% 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 311% of the Medicare baseline (a markup of 211%). 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
Triwest Va Pccc-All Plans $81 - $1,370 23%
Amerigroup Mcr Adv-All Other Plans $82 - $1,398 23%
Care Improvement Plus - All Other Plans $82 - $1,398 23%
Care Improvement Plus Mcr $82 - $1,412 23%
Superior Allwell Mcr Adv-All Other Plans $82 - $1,398 23%
UnitedHealthcare $82 - $3,994 23%
Universal American Mcr-All Other Plans $82 - $1,398 23%
Universal American Snp $87 - $1,468 24%
Ambetter / Centene $98 - $1,678 27%
Coventry First Hlth Hmo Ppo-All Other Plans $103 - $3,994 29%
Coventry First Hlth Mcr Adv $103 - $1,398 29%
Galaxy Health Network-All Plans $119 - $4,244 33%
Capstar Health Network-All Plans $183 - $3,994 51%
Cigna $183 - $3,745 51%
Healthcare Highways-All Plans $198 - $3,994 56%
Prime Healthcare Services-All Plans $214 - $3,495 60%
Blue Cross Blue Shield $229 - $1,202 64%
Humana $244 - $3,994 68%
Corvel Work Comp-All Plans $259 - $4,244 73%
Independent Med Sys Ppo-All Plans $259 - $4,244 73%
Multiplan Mcr Adv $259 - $1,398 73%
Multiplan Phcs Ppo-All Other Plans $259 - $4,244 73%
Provider Select Ppo-All Plans $259 - $4,244 73%
Three Rivers Ppo-All Plans $259 - $4,244 73%
Usa Mso - All Plans $259 - $4,244 73%
Amerigroup Chip $305 - $2,397 86%
Amerigroup Star $305 - $2,397 86%
Amerigroup Star Kids $305 - $2,397 86%
Amerigroup Star Plus $305 - $2,397 86%
Comm Health Chip $305 - $2,397 86%
Comm Health Perinatal-All Other Plans $305 - $2,397 86%
Molina Chip/Star-All Plans $305 - $2,397 86%
Scott & White Chip/Star-All Plans $305 - $2,397 86%
Superior Chip/Star $305 - $2,397 86%
Texas Childrens Hp - All Plans $305 - $2,397 86%
Comm Health Mcaid Hmo $320 - $2,516 90%
Comm Health Star $320 - $2,516 90%
Aetna $3,994 1121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals