CT abdomen and pelvis with contrast at Johnson Memorial Hospital. CPT 74177.
What Johnson Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$897cash price (self-pay)
$1,630list price
$386–$1,630range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Connecticut Dept Of Correction | Connecticut Dept Of Corrections | $386 |
| United Healthcare Medicare | United Healthcare Medicare Advantage | $410 |
| Medigold Medicare Advantage | Mount Carmel Health Plan Medicare Adv | $410 |
| Blue Cross - Ct (Anthem) Medicare Advantage | Anthem Mediblue Medicare | $410 |
| Fallon Health Medicare Advantage | Fallon Medicare Advantage | $418 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $418 |
| Wellcare Medicare | Wellcare Medicare Advantage | $418 |
| Cigna Medicare Advantage | Cigna Medicare Advantage | $422 |
| Prime Health Services Medicare Advantage | Prime Health Medicare Advan | $427 |
| Nippon Life Ins | Aetna | $730 |
| 1199 National Benefit Fund | Aetna | $730 |
| Hap | Aetna | $730 |
| Diversified Administrators | Claimdoc | $878 |
| Innovative Health Plan II | Innovative Health Plan | $878 |
| Centivo | Centivo | $974 |
| Blue Cross - Nv (Anthem) | Anthem | $1,041 |
| Blue Cross - Nh (Anthem) | Anthem | $1,041 |
| Blue Cross - Nj (Horizon) | Anthem | $1,041 |
| Blue Cross - Mt | Anthem | $1,041 |
| Blue Cross - MA | Anthem | $1,041 |
| Blue Cross - Ms | Anthem | $1,041 |
| Blue Cross - La | Anthem | $1,041 |
| Blue Cross - Me (Anthem) | Anthem | $1,041 |
| Blue Cross - Wy | Anthem | $1,041 |
| Blue Cross - Md (Carefirst) | Anthem | $1,041 |
| Kaiser Domestic | Anthem | $1,041 |
| Blue Benefit Administrators Of Massachusetts | Anthem | $1,041 |
| Blue Care Network | Anthem | $1,041 |
| Pre-Employment | Anthem | $1,041 |
| Wc Domestic | Anthem | $1,041 |
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