CT abdomen and pelvis with contrast at Doctors Hospital Of Augusta. CPT 74177.
What Doctors Hospital Of Augusta publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$16,564cash price (self-pay)
$16,564list price
$122–$14,908range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | Hpn | $330 |
| BCBS | Hix | $360 |
| BCBS | Pathway | $360 |
| BCBS | HMO | $408 |
| Health One Alliance | COMMHIX | $429 |
| BCBS | PPO | $437 |
| Blue Choice | Mgmcd | $443 |
| Peach State (Ambetter) | HIX | $479 |
| Aetna | HMO | $548 |
| Aetna | OpenAccess | $548 |
| Aetna | POS | $548 |
| Aetna | PPO | $548 |
| Aetna | QualifiedHealthPlan | $548 |
| United | AllPayerAppendix | $828 |
| Prime Health | WORKERSCOMP | $898 |
| Rockport United Network | WORKERSCOMP | $917 |
| Identity MCO | WorkersComp | $936 |
| Amerigroup | MCD | $2,352 |
| United | OptionsPPO | $2,584 |
| Absolute Total Care | MCD | $2,982 |
| NHC Advantage | MGMCR | $3,147 |
| Pruitt Health | MCR | $3,147 |
| Peach State | MGMCD | $3,313 |
| Wellcare | MCD | $3,313 |
| Americas 1st Choice | MCR | $4,638 |
| United | GlobalBenefitPlan | $7,454 |
| Medcost | NEWULTRA | $8,299 |
| Aetna | NAP | $9,132 |
| MultiPlan | Primary | $9,939 |
| Medcost | STANDARD | $10,585 |
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