CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Community Memorial Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $3,536
  • Cash Discount Price: $2,819
  • vs. Medicare Baseline: 9.92x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Community Memorial Hospital is $3,536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,819. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 9.92x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.
Cash / Self-Pay
$2,819

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,536

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: $2,819 (791%)
Insurance Median: $3,536 (992%)
Cash: $2,819 (791% of Medicare)
Ins. Median: $3,536 (992% 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 992% of the Medicare baseline (a markup of 892%). 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
Allwell $347 97%
Blue Cross Blue Shield $347 - $4,356 97%
Community Care $347 97%
Health Partners $347 - $3,331 97%
Humana $347 97%
Icare $347 97%
Network Health Plan $347 - $1,033 97%
Security Health Plan $347 97%
UnitedHealthcare $347 - $1,691 97%
Aetna $354 - $3,588 99%
Care Wisconsin/Mychoice $357 100%
Centivo $1,538 - $1,691 432%
Sheboygan Employers Health Network $1,671 469%
Froedtert South $2,152 604%
Chorus Community Health Plan $2,204 618%
Common Ground $3,075 863%
Trilogy $3,536 992%
Health Payment Systems $3,565 1000%
Wisconsin Physician Services $3,588 1007%
Aspirus $4,100 1150%
Ibsi Passport $4,151 1165%
Americas Choice $4,459 1251%
Federated Mutual $4,459 1251%
Healtheos $4,459 1251%
Multiplan/Private Healthcare Systems $4,459 1251%
Savility $4,459 1251%
Cigna $4,510 1265%
First Health Network $4,510 1265%
Healthsmart $4,612 1294%
Physicians Plus $4,612 1294%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: W180 N8085 Town Hall Rd, Menomonee Falls, WI 53051
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals