CT abdomen and pelvis with contrast at Madison County Memorial Hospital. CPT 74177.
What Madison County Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 30, 2026.
Outpatient / ER
$328cash price (self-pay)
$1,683list price
$17.60–$1,842range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Clear_alliance | Medicaid | $17.60 |
| Humana_medicaid_advantage_hmo | Medicaid | $17.60 |
| Humana_medicaid_advantage_traditional | Medicaid | $17.60 |
| Lighthouse_medicaid_advantage | Medicaid | $17.60 |
| Magellan | Medicaid | $17.60 |
| Molina_florida_kid_care | Medicaid | $17.60 |
| Molina_medicaid_advantage | Medicaid | $17.60 |
| Prestige_health_choice | Medicaid | $17.60 |
| Simply_health_medicaid_advantage | Medicaid | $17.60 |
| Sunshine_medicaid_advantage | Medicaid | $17.60 |
| Wellcare | Medicaid | $17.60 |
| Youth_services | Medicaid | $17.60 |
| Prime_health | Medicare | $36.53 |
| Uhc_medicaid_advantage | Medicaid | $138 |
| Aetna | Commercial | $177 |
| UHC | Commercial | $223 |
| Multiplan | Commercial | $245 |
| Multiplan_complimentary_network | Commercial | $245 |
| BCBS | Commercial | $456 |
| Humana_epo | Commercial | $542 |
| Humana_hmo | Commercial | $542 |
| Humana_pos | Commercial | $542 |
| Humana_ppo | Commercial | $542 |
| Aetna_medical_rental | Commercial | $1,842 |
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