CT abdomen and pelvis with contrast at Franklin General Hospital. CPT 74177.
What Franklin General Hospital publishes for this service, straight from its standard-charges file, last updated July 16, 2026.
Outpatient / ER
$3,896cash price (self-pay)
$4,329list price
$1,042–$4,113range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellmark HMO | Wellmark HMO | $1,042 |
| Wellmark PPO - All Other Plans | Wellmark PPO - All Other Plans | $1,146 |
| Medical Associates Mcare | Medical Associates Mcare | $1,732 |
| Mount Carmel Hp-All Plans | Mount Carmel Hp-All Plans | $1,732 |
| Tricare - All Plans | Tricare - All Plans | $1,732 |
| UHC Va Ccn | UHC Va Ccn | $1,732 |
| Amerigroup Mcare | Amerigroup Mcare | $1,749 |
| Wellmark Mcr Adv | Wellmark Mcr Adv | $1,749 |
| UHC Mcr Adv | UHC Mcr Adv | $1,784 |
| Molina Mcare | Molina Mcare | $1,801 |
| American Hp Iowa - All Plans | American Hp Iowa - All Plans | $1,818 |
| Centene Mcare Adv | Centene Mcare Adv | $1,818 |
| Centene Mcaid | Centene Mcaid | $1,943 |
| Amerigroup Mcaid - All Other Plans | Amerigroup Mcaid - All Other Plan | $1,962 |
| Molina Mcaid - All Other Plans | Molina Mcaid - All Other Plans | $1,971 |
| Centivo - All Plans | Centivo - All Plans | $2,597 |
| Medical Ass Hosp Employer Group | Medical Ass Hosp Employer Group | $2,597 |
| Oscar - All Plans | Oscar - All Plans | $2,597 |
| Centene Comm - All Other Plans | Centene Comm - All Other Plans | $2,771 |
| Midlands Choice-All Plans | Midlands Choice-All Plans | $3,030 |
| UHC All Payer-All Other Plans | UHC All Payer-All Other Plans | $3,597 |
| Medical Associates Hp-All Other Plans | Medical Associates Hp-All Othe | $3,680 |
| Preferred Health Choices-All Plans | Preferred Health Choices-All Plan | $3,680 |
| Splashlight LLC-All Plans | Splashlight LLC-All Plans | $3,680 |
| Aetna/Coventry HMO | Aetna/Coventry HMO | $4,026 |
| Aetna/Coventry PPO - All Other Plans | Aetna/Coventry PPO - All Other | $4,113 |
| Multiplan-All Plans | Multiplan-All Plans | $4,113 |
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