CT abdomen and pelvis with contrast at Jackson South Medical Center. CPT 74177.
What Jackson South Medical Center publishes for this service, straight from its standard-charges file, last updated September 23, 2026.
Outpatient / ER
$392cash price (self-pay)
$5,999list price
$204–$10,192range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth Mcaid | Amerihealth Mcaid | $204 |
| UHC Mcaid | UHC Mcaid | $204 |
| Wellcare Mcaid | Wellcare Mcaid | $204 |
| Aetna Better Hlth Mcaid | Aetna Better Hlth Mcaid | $204 |
| Aetna Better Hlth Chip | Aetna Better Hlth Chip | $225 |
| Wellcare Hlthy Kids - All Other Plans | Wellcare Hlthy Kids - All Othe | $225 |
| Avmed Mcr Adv | Avmed Mcr Adv | $346 |
| Humana Mcr Adv | Humana Mcr Adv | $353 |
| Centene Bh Mcr - All Plans | Centene Bh Mcr - All Plans | $364 |
| Health Spring - All Plans | Health Spring - All Plans | $364 |
| Sunshine Mcr Adv | Sunshine Mcr Adv | $364 |
| Va Ccn - All Plans | Va Ccn - All Plans | $364 |
| Devoted Mcr Adv - All Plans | Devoted Mcr Adv - All Plans | $375 |
| Comm Care Mcr Adv | Comm Care Mcr Adv | $383 |
| Ambetter Exch - All Plans | Ambetter Exch - All Plans | $401 |
| Longevity Hp - All Plans | Longevity Hp - All Plans | $408 |
| Align Mcr Adv - All Plans | Align Mcr Adv - All Plans | $408 |
| Avmed Exch | Avmed Exch | $506 |
| Amerihealth Exch - All Other Plans | Amerihealth Exch - All Other Plan | $510 |
| Avmed Select/First Ntwrk | Avmed Select/First Ntwrk | $524 |
| Cigna Surefit Ifp | Cigna Surefit Ifp | $593 |
| Curative - All Plans | Curative - All Plans | $600 |
| Humana Comm - All Other Plans | Humana Comm - All Other Plans | $631 |
| Avmed Comm - All Other Plans | Avmed Comm - All Other Plans | $649 |
| UHC Options PPO | UHC Options PPO | $663 |
| Claimdoc - All Plans | Claimdoc - All Plans | $710 |
| Cigna HMO/PPO - All Other Plans | Cigna HMO/PPO - All Other Plans | $750 |
| BCBS FL Blue Bsl | BCBS FL Blue Bsl | $817 |
| BCBS FL Blue HMO | BCBS FL Blue HMO | $1,013 |
| Aetna Exchange | Aetna Exchange | $1,071 |
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