CT abdomen and pelvis with contrast at University of Michigan Health-Sparrow Ionia. CPT 74177.
What University of Michigan Health-Sparrow Ionia publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$86.00cash price (self-pay)
$172list price
$18.52–$4,401range 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 | $356 |
| Priority Health MediHMO | HMO | $356 |
| Blue Cross Complete Medicaid | HMO | $356 |
| McLaren Medicaid | HMO | $356 |
| Aetna Medicaid | HMO | $374 |
| Molina Medicaid | HMO | $392 |
| Medicare | Part A&B | $1,235 |
| Covenant Advantage | Part A&B | $1,235 |
| MediGold | Part A&B | $1,235 |
| Senior Community Care | Part A&B | $1,235 |
| BCN Medicare Advantage | Part A&B | $1,235 |
| Medicare Plus Blue | Part A&B | $1,235 |
| Aetna Medicare Advantage | Part A&B | $1,235 |
| Humana Medicare Advantage | Part A&B | $1,296 |
| Priority Health Medicare Advantage | Part A&B | $1,310 |
| HAP Medicare Advantage | Part A&B | $1,310 |
| McLaren Medicare Advantage | Part A&B | $1,310 |
| Priority | PPO | $3,031 |
| Blue Cross Blue Shield | PPO | $3,097 |
| Aetna | PPO | $3,704 |
| United Health Care | PPO | $3,788 |
| Cigna | PPO | $3,912 |
| Great West Healthcare | PPO | $3,912 |
| Asr | PPO | $3,951 |
| Health Alliance Plan | PPO | $3,951 |
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All common services at University of Michigan Health-Sparrow Ionia