CT abdomen and pelvis with contrast at Horn Memorial Hospital. CPT 74177.
What Horn Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2026.
Outpatient / ER
$4,098cash price (self-pay)
$5,123list price
$86.03–$5,021range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Comm - All Other Plans | Aetna Comm - All Other Plans | $86.03 |
| Triwest - All Plans | Triwest - All Plans | $353 |
| Wellmark HMO - All Other Plans | Wellmark HMO - All Other Plans | $375 |
| Wellmark PPO | Wellmark PPO | $414 |
| UHC Va Ccn | UHC Va Ccn | $3,023 |
| Aetna Mcr Adv | Aetna Mcr Adv | $3,023 |
| Amerigroup Mcr Adv | Amerigroup Mcr Adv | $3,023 |
| Molina Mcr - All Other Plans | Molina Mcr - All Other Plans | $3,023 |
| UHC Mcare | UHC Mcare | $3,023 |
| Molina Medicaid | Molina Medicaid | $3,227 |
| Amerigroup Mcaid - All Other Plans | Amerigroup Mcaid - All Other Plan | $3,227 |
| UHC Mcaid | UHC Mcaid | $3,227 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $5,021 |
| UHC Options PPO | UHC Options PPO | $5,021 |
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