CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Lewisgale Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $10,215
Cash Discount Price: $17,025
vs. Medicare Baseline: 28.66x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Lewisgale Medical Center is $10,215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,025. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 28.66x the Medicare baseline. Located in 1900 Electric Road, Salem, VA.

Cash / Self-Pay

$17,025

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,215

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: $17,025 (4777%)

Insurance Median: $10,215 (2866%)

Cash: $17,025 (4777% of Medicare)

Ins. Median: $10,215 (2866% 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 2866% of the Medicare baseline (a markup of 2766%). 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
Blue Cross Blue Shield	$382 - $1,573	107%
United	$828 - $7,661	232%
Aetna	$2,807 - $4,356	788%
Cigna	$2,962	831%
Lifeworks	$3,235	908%
Universal Healthcare Group	$3,746	1051%
Virginia Health Network	$5,959 - $12,088	1672%
Naphcare	$8,512	2388%
Greenvbrier Sporting Club	$10,215	2866%
Graham-White Manufacturing	$11,918	3344%
Richfield Nursing Center	$11,918	3344%
Corvel	$12,258	3439%
Community Care Network	$12,769	3582%
Richfield Retirement Community	$12,769	3582%
Csx Hotels	$13,620	3821%
Occunet Workers Comp	$13,620	3821%
One Health Plan	$13,620	3821%
Patients Choice	$14,982	4203%
4Most	$15,322	4299%
Alleghany Highland Community	$15,322	4299%
American Postal Workers Union	$15,322	4299%
C&O Employees Hospital Assn	$15,322	4299%
Multiplan	$15,322	4299%
Phcs	$15,322	4299%
Star Transportation	$15,322	4299%

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 $17,025.
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 Lewisgale Medical Center 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.