CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Oakleaf Surgical Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $346
  • Cash Discount Price: $1,496
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Oakleaf Surgical Hospital is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,496. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$1,496

Average discount available for prompt cash payment at this facility.

Insurance Median
$346

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: $1,496 (420%)
Insurance Median: $346 (97%)
Cash: $1,496 (420% of Medicare)
Ins. Median: $346 (97% 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.

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 $346 - $1,748 97%
Dean Health Plan $346 97%
Group Health Cooperative Of Eau Claire $346 97%
Healthpartners $346 97%
Humana $346 97%
Medica $346 97%
Quartz Health Solutions $346 97%
Security Health Plan Of Wi $346 - $876 97%
Ucare Wi $346 97%
UnitedHealthcare $346 97%
Alliance $1,728 485%

Consumer Guidance & Cost Commentary

For this CT scan of the abdomen and pelvis with contrast at Oakleaf Surgical Hospital in Altoona, WI, the cash price of $1,496 is notably lower than the facility's gross charge of $1,663. While the hospital's negotiated rates for in-network patients range from a low of $346 to a high of $1,748 depending on the specific insurance carrier, the cash rate provides a clear baseline for self-pay patients. It is important to note that for many commercial payers, the negotiated rate of $346 is significantly lower than the cash price of $1,496, meaning insurance members would likely pay less through their plans than by paying out-of-pocket. Additionally, the Medicare benchmark amount for this service is $356.43, which serves as a federal cost baseline; commercial negotiated rates here are higher than the Medicare rate, reflecting the administrative costs and contract structures associated with private insurance.

Patients should be aware that hospitals often offer prompt-pay discounts for those who settle bills upfront, which can reduce the cash price further, though these discounts must be requested before check-in to avoid automatic claim submission. If a patient chooses to use insurance, the negotiated rate of $346 applies to most carriers listed, such as Blue Cross Blue Shield, Dean Health Plan, and UnitedHealthcare, while Alliance has a fixed negotiated rate of $1,728. Because the cash price of $1,496 exceeds the majority of these negotiated rates, patients with high-deductible plans who have not yet met their out-of-pocket maximum should carefully compare their expected insurance liability against the cash option. To ensure the lowest possible cost, patients

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals