CT abdomen and pelvis with contrast at Atrium Health Floyd Polk Medical Center. CPT 74177.
What Atrium Health Floyd Polk Medical Center publishes for this service, straight from its standard-charges file, last updated November 19, 2025.
Outpatient / ER
$4,875cash price (self-pay)
$9,750list price
$250–$8,775range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Local Plus Commercial | $250 |
| Anthem | HMO/Pathway X | $486 |
| Anthem | PPO | $486 |
| United Healthcare | Commercial | $700 |
| Alliant Health Plans | Simplecare Commercial | $873 |
| Amerigroup | Managed Medicaid | $1,326 |
| Peach State Health Plan | Managed Medicaid | $1,339 |
| CareSource | Managed Medicaid | $1,339 |
| Oscar Health Plan | Commercial | $1,901 |
| AWC Networks | Commercial | $1,902 |
| Aetna | Medicare Advantage | $1,950 |
| Cigna | Medicare Advantage | $1,950 |
| Anthem | Medicare Advantage | $1,950 |
| Georgia Assurance | Medicare Advantage | $1,950 |
| CareSource | Medicare Advantage | $1,950 |
| Humana | Medicare Advantage | $1,950 |
| United Healthcare | Medicare Advantage | $1,950 |
| Wellcare | Medicare Advantage | $1,950 |
| Alliant Health Plans | SoloCare Commercial | $2,438 |
| Clover | Medicare Advantage | $2,535 |
| CareSource | Marketplace Exchange | $2,925 |
| Ambetter | Marketplace Exchange | $2,925 |
| Humana ChoiceCare | Commercial | $4,388 |
| Cigna | Floyd County and Rome City Commercial | $5,168 |
| Cigna | Commercial | $5,850 |
| Aetna | Commercial | $6,240 |
| Aetna First Health | Commercial | $6,630 |
| Multiplan | Commercial | $6,825 |
| Anthem | Indemnity | $7,282 |
| Private Health Care Systems | Commercial | $8,288 |
Inpatient
$4,875cash price (self-pay)
$9,750list price
$3,413–$8,775range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Oscar Health Plan | Commercial | $3,413 |
| Cigna | Floyd County and Rome City Commercial | $5,168 |
| Multiplan | Commercial | $6,825 |
| Anthem | Indemnity | $7,282 |
| Beech Street | Commercial | $8,775 |
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All common services at Atrium Health Floyd Polk Medical Center