CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 74177 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$513

about 1.4× the $356 Medicare rate · typically $206–$2,714

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,933

Well above the fair price

about $1,420 over the fair price · 5.4× Medicare

Medicare pays $356 Fair price $513 This hospital $1,933 Cash price $2,053 Hospital's list price $4,001

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $93 Priciest $1,933

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

A fair price for a CT scan, abdomen and pelvis (with contrast) is about $513 (about 1.4× the $356 Medicare rate). Gundersen Moundview Hospital and Clinics charges insurers about $1,933, or about $2,053 in cash — well above the fair price. Located in Friendship, WI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $513. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$1,221	343%
Blue Cross Blue Shieldmajor	$990 - $4,968	278%
Aetnamajor	$3,801	1066%
Humanamajor	$3,401	954%
Amerigroup	$138	39%
Dean Health Plan	$1,871	525%
HealthPartners	$1,840 - $3,533	516%
Quartz	$2,181	612%
Security Health Plan	$1,840	516%
UCare	$1,840 - $3,201	516%
+ 5 smaller / regional plans	$990 - $3,801

Excludes 1 rental-network / third-party entry (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 2,053), 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 Gundersen Moundview Hospital and Clinics 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 Gundersen Moundview Hospital and Clinics

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

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