CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Forks Community Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,886
Cash Discount Price: $3,528
vs. Medicare Baseline: 5.29x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Forks Community Hospital is $1,886. 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 5.29x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$3,528

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,886

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: $1,886 (529%)

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

Ins. Median: $1,886 (529% 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 529% of the Medicare baseline (a markup of 429%). 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
Medicare (plans)	$318	89%
Medicaid / KanCare	$652 - $2,541	183%
Coordinated Care (Mco) Mcd-All Plans	$704 - $2,589	198%
UnitedHealthcare	$839 - $5,893	235%
Community Health Network Mcr-All Other Plans	$849 - $3,120	238%
Humana	$849 - $3,120	238%
Tricare	$849 - $3,120	238%
Triwest-All Plans	$849 - $3,120	238%
Ambetter / Centene	$984 - $3,619	276%
Wellcare Med Adv - All Plans	$984 - $3,619	276%
Regence-All Other Plans	$1,086 - $3,992	305%
Community Health Exchange	$1,226 - $4,506	344%
Molina Commercial-All Other Plans	$1,735 - $6,378	487%
Aetna	$1,792 - $6,586	503%
Blue Cross Blue Shield	$1,792 - $6,586	503%
Cigna	$1,886 - $6,933	529%
First Choice-All Plans	$1,886 - $6,933	529%

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 Forks Community Hospital 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.