CT abdomen and pelvis with contrast at University of Michigan Health-Sparrow Clinton. CPT 74177.
What University of Michigan Health-Sparrow Clinton publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$86.00cash price (self-pay)
$172list price
$11.00–$14,247range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid | Professional | $54.95 |
| Medicaid | Professional Facility | $54.95 |
| Medicare | Professional | $82.11 |
| BCBS | Professional | $137 |
| BCBS | Professional Facility | $137 |
| Medicaid | CAID | $251 |
| Priority Health Medicaid | HMO | $251 |
| Blue Cross CompleteMedicaid | HMO | $251 |
| MclarenMedicaid | HMO | $251 |
| AetnaMedicaid | HMO | $261 |
| MolinaMedicaid | HMO | $276 |
| Medicare | Part A & B | $1,235 |
| Covenant Advantage | HMO | $1,235 |
| Medigold | HMO | $1,235 |
| Senior Community Health | HMO | $1,235 |
| BCN Medicare Advantage | HMO | $1,235 |
| Medicare Plus Blue | HMO | $1,235 |
| Aetna Medicare Advantage | HMO | $1,235 |
| Humana Medicare Advantage | HMO | $1,296 |
| HAP Medicare Advantage | HMO | $1,296 |
| Mclaren Medicare Advantage | HMO | $1,296 |
| Priority Health Medicare Advantage | HMO | $1,310 |
| Blue Cross Blue Shield | PPO | $2,466 |
| Aetna | PPO | $3,704 |
| Priority | PPO | $3,739 |
| United Health | PPO | $3,788 |
| Humana | PPO | $3,852 |
| Cigna | PPO | $3,912 |
| Great West Health | PPO | $3,912 |
| Cofinity | PPO | $4,001 |
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All common services at University of Michigan Health-Sparrow Clinton