CT abdomen and pelvis with contrast at Wayne Memorial Hospital. CPT 74177.
What Wayne Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$1,239cash price (self-pay)
$2,478list price
$1,524–$2,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross PAR PPO | PPO | $1,524 |
| Blue Cross Open Access HMO | HMO | $1,524 |
| CIGNA Healthgram City Employee | Contract | $1,660 |
| AETNA | Commercial | $1,817 |
| First Health | Commercial | $1,859 |
| CIGNA | Commercial | $1,888 |
| HUMANA ChoiceCare | Commercial | $1,982 |
| United Healthcare | Commercial | $2,082 |
| PHCS | Commercial | $2,230 |
| Super Med | Commercial | $2,230 |
Inpatient
$1,239cash price (self-pay)
$2,478list price
$1,660–$2,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CIGNA Healthgram City Employee | Contract | $1,660 |
| AETNA | Commercial | $1,817 |
| First Health | Commercial | $1,859 |
| CIGNA | Commercial | $1,888 |
| HUMANA ChoiceCare | Commercial | $1,982 |
| United Healthcare | Commercial | $2,082 |
| PHCS | Commercial | $2,230 |
| Super Med | Commercial | $2,230 |
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