CT abdomen and pelvis with contrast at CHI Memorial Hospital - Georgia. CPT 74177.
What CHI Memorial Hospital - Georgia publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$715cash price (self-pay)
$2,414list price
$302–$1,955range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Commercial|LocalPlus | $302 |
| Cigna | Commercial|Open Access | $302 |
| Aetna | Medicare|All Plans | $319 |
| BCBS - GA | Medicare|BlueCare | $329 |
| Cigna | Medicare|Healthspring | $335 |
| Humana | Medicare|HMO | $338 |
| Amerigroup | Medicare|All Plans | $342 |
| Humana | Medicare|All Other Plans | $351 |
| Peach State | Medicaid|All Plans | $362 |
| BCBS - TN | Commercial|Network S | $449 |
| Employers Health Network | Commercial|All Plans | $455 |
| Amerigroup | Medicaid|All Plans | $459 |
| CareSource | Medicaid|All Plans | $483 |
| Wellcare | Medicaid|All Plans | $483 |
| Centene | Commercial|Ambetter Exchange | $546 |
| BCBS - GA | Commercial|Pathway | $561 |
| BCBS - TN | Commercial|Network P | $566 |
| Alliant Health | Commercial|All Plans | $759 |
| United | Commercial|Non-Options | $766 |
| United | Commercial|Options | $766 |
| BCBS - GA | Commercial|All Other Plans | $782 |
| BCBS - GA | Commercial|HMO | $782 |
| Humana | Commercial|All Plans | $1,389 |
| Multiplan | Commercial|All Plans | $1,448 |
| Health One Alliance | Commercial|All Plans | $1,467 |
| Aetna | Commercial|All Other Plans | $1,955 |
| Aetna | Commercial|HMO | $1,955 |
| Aetna | Commercial|PPO | $1,955 |
Inpatient
$715cash price (self-pay)
$2,414list price
$1,955–$1,955range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Commercial|All Other Plans | $1,955 |
| Aetna | Commercial|HMO | $1,955 |
| Aetna | Commercial|PPO | $1,955 |
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