CT abdomen and pelvis with contrast at BSA Hospital. CPT 74177.
What BSA Hospital publishes for this service, straight from its standard-charges file, last updated February 12, 2026.
Outpatient / ER
$893cash price (self-pay)
$8,934list price
$312–$7,594range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Umr - Ardent Employee [2036] | Umr - Ardent Employee [203601] | $2,978 |
| Healthcare Highways [2210] | Hch John Soules Foods [221011] | $3,484 |
| Healthcare Highways [2210] | Hch Broken Arrow [221012] | $3,484 |
| Healthcare Highways [2210] | Hch 90 Degree Benefits [221013] | $3,484 |
| Oncology Patient Assistance Programs [2295] | Bccs Family Circle Of CA | $3,484 |
| Horizon Nj Health [3635] | Horizon Nj Health [363500] | $3,484 |
| Curative [7085] | Curative [708500] | $3,484 |
| Umr [2035] | Umr Oon Potter Co [203506] | $3,484 |
| Midland Pace Mcaid [3715] | Midland Pace Mcaid [371500] | $3,484 |
| American Healthcare [1055] | American Healthcare [105500] | $4,467 |
| Sana Benefits [5005] | Sana Benefits [500500] | $4,467 |
| Texas Rehabilitation [1970] | Texas Workforce Commission [197000] | $5,092 |
| Nreca [1735] | Nreca [173500] | $5,477 |
| Pan American Life Insurance Co [1770] | Pan American Life [177000] | $6,254 |
| Northamerica Administrators [1725] | Northamerica Administrators [1725 | $6,254 |
| Rh Administrators [1885] | Rh Administrators [188500] | $6,254 |
| Phcs [1780] | Phcs Multiplan [178000] | $6,254 |
| Phcs [1780] | Freedom Life [178009] | $6,254 |
| Principal Mutual Life [1845] | Principal Colorado Claims [184500] | $6,254 |
| Phoenix Home Life [1785] | Phoenix Home Life [178500] | $6,254 |
| Beech Street [1170] | Beech Street/Cappcare Misc [117000] | $6,254 |
| Comcar Industries [1280] | Comcar Industries [128000] | $6,254 |
| Celtic Life [1220] | Celtic Life [122000] | $6,254 |
| Americas Choice Health Plans [1090] | Americas Choice Health Plans [10 | $6,254 |
| Mega Life And Health [1650] | Mega Life Heatlh [165001] | $6,254 |
| Cherokee Insurance [1245] | Cherokee Insurance [124500] | $6,254 |
| Alieracare [2935] | Trinity Healthshare [293500] | $6,254 |
| National Association Of Letter Carriers [1695] | Nalc [169500] | $6,486 |
| Cigna [1260] | Cigna [126008] | $6,486 |
| Healthpartners [1500] | Healthpartners [150000] | $6,486 |
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