CT abdomen and pelvis with contrast at Northeast Georgia Medical Center Braselton. CPT 74177.
What Northeast Georgia Medical Center Braselton publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$2,009cash price (self-pay)
$4,752list price
$343–$525range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross | State Health Benefit Plan Medicare Managed Care Plan | $343 |
| Aetna | Medicare Managed Care Plan | $350 |
| Cigna | Healthspring Medicare Managed Care Plan | $354 |
| Humana | Medicare Managed Care Plan | $360 |
| Bcbs | Anthem Hmo | $525 |
| Bcbs | Anthem Ppo | $525 |
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All common services at Northeast Georgia Medical Center Braselton