CT abdomen and pelvis with contrast at Wolfson Children's Hospital. CPT 74177.
What Wolfson Children's Hospital publishes for this service, straight from its standard-charges file, last updated February 6, 2026.
Outpatient / ER
$2,682cash price (self-pay)
$4,325list price
$207–$4,239range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup of Georgia | Managed Medicaid OOS | $207 |
| Amerihealth Caritas | Managed Medicaid | $228 |
| Aetna Better Health | Healthy Kids | $248 |
| Aetna Better Health | Managed Medicaid | $248 |
| Community Hospice of Northeast Florida | Medicare Advantage | $357 |
| Aetna | Medicare Advantage | $364 |
| UPMC | Medicare Advantage | $393 |
| BCBS | Blue Select | $453 |
| BCBS | My Blue | $453 |
| Aetna | Whole Health | $511 |
| Aetna | Whole Health -Child | $511 |
| AvMed | Engage & Empower & Entrust - Child | $549 |
| AvMed | Engage & Empower & Entrust | $549 |
| BCBS | Network Blue | $567 |
| BCBS | PPO | $567 |
| BCBS | Indemnity | $567 |
| BCBS | HMO | $567 |
| Centivo | Select | $595 |
| AvMed | All Products | $656 |
| Aetna | Non-Gatekeeper | $669 |
| Aetna | Gatekeeper | $669 |
| Aetna | QHP | $669 |
| Ambetter | Marketplace - All Products | $857 |
| BCBS | Medicare Advantage | $1,254 |
| Borland Groover | All Products | $1,730 |
| Cigna | HMO | $1,817 |
| Cigna | Gatekeeper New Business | $1,860 |
| Capital Health Plan | All Products | $1,990 |
| Aetna | SRC and NAP | $2,206 |
| Corvel | Managed WC | $2,241 |
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