CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Stoughton Hospital

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $1,870
Cash Discount Price: $3,428
vs. Medicare Baseline: 5.25x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Stoughton Hospital is $1,870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,428. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 5.25x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$3,428

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,870

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: $3,428 (962%)

Insurance Median: $1,870 (525%)

Cash: $3,428 (962% of Medicare)

Ins. Median: $1,870 (525% 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 525% of the Medicare baseline (a markup of 425%). 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
Medicaid / KanCare	$392	110%
Quartz Health Solutions - All Other Lans	$780	219%
Tricare	$1,483	416%
Dean Health Insurance Comm - All Other Plans	$1,653	464%
Dean Health Insurance Epo	$1,653	464%
Healthnet Mcr Adv - All Plans	$1,658	465%
Dean Health Insurance Med Adv	$1,745	490%
Humana	$1,745 - $5,610	490%
Quartz Mcr Adv	$1,745	490%
Security Health/First Health - All Plans	$1,745	490%
Aetna	$1,870 - $5,298	525%
UnitedHealthcare	$2,743 - $4,986	770%
Geha - All Plans	$4,675	1312%
Cigna	$4,986	1399%
Wisconsin Ppo Ppa Direct - All Plans	$4,986	1399%
Blue Cross Blue Shield	$5,423	1521%
Wps - All Plans	$5,610	1574%
Alliance - All Plans	$24,932	6995%

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 $3,428.
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 Stoughton 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.