Aultman Orrville Hospital
Critical Access Hospital
832 South Main Street, Orrville, OH 44667
How this provider stacks up
$1,541
This provider's rate
Lowest
$219
Highest
$9,467
This is this provider's self-pay (cash) rate. See how it compares to rates from other providers in this area.
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CT of Abdomen and Pelvis Overview
This list includes the services and fees bundled into the CT of Abdomen and Pelvis Standard Service Package (SSP RA004). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS 74177 | Base Code | CT of abdomen and pelvis |
| HCPCS 74177 | Professional | CT of abdomen and pelvis |
| RC 0352 | Facility | CT Scan - Body scan |
| HCPCS Q9967 | Facility | Non-ionic low osmolar contrast, 300-399mg/ml iodine concentration per ml |
| RC 0636 | Facility | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| HCPCS 71260 | Facility | CT thorax scan with contrast injection |
| HCPCS 80053 | Facility | Comprehensive Metabolic Panel |
Your Right to Know (and Save)
The No Surprises Act requires healthcare providers to give you a cost estimate for certain services. We've made it easier by grouping common services into Standard Service Packages (SSPs), so you can see the typical services and costs that are usually bundled together. Here's how to use this estimate to avoid surprise bills and shop around confidently:
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Review this estimate and others nearby to see how costs can vary for the full procedure.
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Ask for a “Good Faith Estimate” and reference the CPT code we provide.
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