CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Ascension Seton Edgar B Davis

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $464
Cash Discount Price: $3,528
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Ascension Seton Edgar B Davis is $464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,528. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 1.30x the Medicare baseline. Located in 130 Hays Street, Luling, TX.

Cash / Self-Pay

$3,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$464

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: $3,528 (990%)

Insurance Median: $464 (130%)

Cash: $3,528 (990% of Medicare)

Ins. Median: $464 (130% 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	$223 - $1,707	63%
Dell Star	$223 - $464	63%
UnitedHealthcare	$223 - $464	63%
Wellpoint Star	$223 - $464	63%
Wellpoint Star Plus	$223 - $464	63%
Champva	$229 - $301	64%
Dell Chip/Chip Perinate	$253 - $464	71%
Ambetter / Centene	$294 - $318	82%
Wellpoint Chip/Chip Perinate	$294 - $464	82%
Wellpoint Star Kids	$318 - $464	89%
Tricare	$336	94%
Humana	$435	122%
Seton Performance Plus	$991	278%
Aetna	$1,345 - $2,375	377%
Cigna	$1,610	452%
Covenant Health	$2,375	666%
Superior Star	$3,060 - $4,779	859%
Superior Star Foster	$3,060 - $4,779	859%
Superior Star Kids	$3,060 - $4,779	859%
Superior Star Plus	$3,060 - $4,779	859%
Superior Chip/Chip Perinate	$3,443 - $5,376	966%

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 $3,528.
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 Ascension Seton Edgar B Davis 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.