CT abdomen and pelvis with contrast at St Marys Sacred Heart Hospital. CPT 74177.
What St Marys Sacred Heart Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2025.
Outpatient / ER
$1,918cash price (self-pay)
$2,950list price
$1.00–$2,508range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Pathway Program | $1.00 |
| Centene | Medicaid | $1.03 |
| Caresource | Marketplace | $1.55 |
| Cigna | All products | $2.44 |
| ChoiceCare | PPO | $293 |
| Peach State | Medicaid | $298 |
| Anthem BCBS | Medicare Advantage | $366 |
| Care Improvement Plus | Medicare Advantage | $366 |
| Kaiser Permanente | Medicare Advantage | $366 |
| UHC | Medicare Advantage | $366 |
| VACCN United | Veterans Affairs | $366 |
| Wellcare | Medicare Advantage | $366 |
| Peach State | Marketplace | $370 |
| Aetna | Medicare Advantage | $374 |
| Conventry | Medicare Advantage | $374 |
| Molina | Medicare Advantage | $374 |
| Humana | Medicare Advantage | $375 |
| Centene | Medicare Advantage | $377 |
| Cigna Healthspring | Medicare Advantage | $377 |
| Caresource | Medicare Advantage | $381 |
| Pruitthealth Premier | Medicare Advantage | $385 |
| Eon Health Plan | Medicare Advantage | $392 |
| Anthem | PPO | $416 |
| Friday Health Plan | Commercial | $641 |
| Anthem | HMO | $1,475 |
| UHC | All Products | $1,732 |
| United Healthcare | All Products | $1,732 |
| Aetna | All Products | $1,735 |
| COVENTRY | All Products | $2,508 |
| First Health | All Products | $2,508 |
Inpatient
$1,918cash price (self-pay)
$2,950list price
$1,732–$2,508range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| COVENTRY | All Products | $2,065 |
| First Health | All Products | $2,065 |
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