CT scan, abdomen and pelvis (with contrast)
Facility: Regional Medical Center
Billing Code: 74177 (CPT)
- CPT Billing Code: 74177
- Insurance Median: $870
- Cash Discount Price: $3,219
- vs. Medicare Baseline: 2.44x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 244% of the Medicare baseline (a markup of 144%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 244% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important takeaway is that the cash price for this CT scan procedure is $3,219, which is significantly lower than the facility's gross charge of $4,024. Because this is a Critical Access Hospital in Manchester, Iowa, it is essential to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment options can reduce the final bill by bypassing administrative fees and collection risks that accompany insurance billing cycles.
When considering insurance coverage, patients should understand that the negotiated rate of $870 paid by Medical Associates Health Plan - Tri is substantially lower than the facility's gross charge, though it remains higher than the Medicare amount of $356.43. This procedure falls under the CPT code 74177, and while the facility is in-network, the contractually agreed-upon rate reflects the administrative costs and volume agreements typical of commercial payers, which often result in higher prices than the federal Medicare benchmark.