CT abdomen and pelvis with contrast at University of Michigan Health-Sparrow Lansing. CPT 74177.
What University of Michigan Health-Sparrow Lansing publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$86.00cash price (self-pay)
$172list price
$54.95–$4,262range 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 | $191 |
| Priority Health Medicaid | HMO | $191 |
| Blue Cross Complete Medicaid | HMO | $191 |
| McLaren Medicaid | HMO | $191 |
| Aetna Medicaid | HMO | $199 |
| Molina Medicaid | HMO | $211 |
| Blue Care Network | PPO | $352 |
| Blue Shield Blue Cross | PPO | $352 |
| Medicare | Part A & B | $357 |
| Covenant Advantage | HMO | $357 |
| MediGold | HMO | $357 |
| Senior Community Care | HMO | $357 |
| BCN Medicare Advantage | HMO | $357 |
| Medicare Plus Blue | HMO | $357 |
| Aetna Medicare Advantage | HMO | $357 |
| Humana Medicare Advantage | HMO | $375 |
| Priority Health Medicare Advantage | HMO | $375 |
| HAP Medicare Advantage | HMO | $375 |
| McLaren Medicare Advantage | HMO | $375 |
| Priority | PPO | $1,852 |
| McLaren Commercial | PPO | $2,121 |
| United Health Care | PPO | $2,305 |
| Health Alliance Plan | PPO | $2,526 |
| Health Alliance Plan | HMO | $2,526 |
| Aetna | PPO | $3,126 |
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All common services at University of Michigan Health-Sparrow Lansing