CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 74177 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$788

about 2.2× the $356 Medicare rate · typically $265–$1,313

modeled estimate · not a bill or quote

What this hospital charges insurers

$776

About the fair price

about $12 under the fair price · 2.2× Medicare

Medicare pays $356 Fair price $788 This hospital $776 Cash price $2,042 Hospital's list price $13,616

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $131 Priciest $776

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $788 (about 2.2× the $356 Medicare rate). CHI St Lukes Health Memorial San Augustine charges insurers about $776, or about $2,042 in cash — about the fair price. Located in San Augustine, TX.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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
UnitedHealthcaremajor	$354 - $13,616	99%
Blue Cross Blue Shieldmajor	$349 - $1,524	98%
Aetnamajor	$339 - $3,404	95%
Cignamajor	$356 - $1,103	100%
Humanamajor	$339 - $9,531	95%
+ 6 smaller / regional plans	$361 - $14,161

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,042), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 74177.

Insurance Before you use insurance

Call your insurance company to confirm CHI St Lukes Health Memorial San Augustine is in-network.
Ask your insurer whether prior approval is required for CPT code 74177.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at CHI St Lukes Health Memorial San Augustine

Compare: CT scan, abdomen and pelvis (with contrast) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.