CT abdomen and pelvis with contrast at Copley Memorial Hospital. CPT 74177.
What Copley Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 26, 2026.
Outpatient / ER
$4,001cash price (self-pay)
$8,002list price
$263–$10,883range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS Mcaid | BCBS Mcaid | $263 |
| Meridian Mcaid - All Other Plans | Meridian Mcaid - All Other Plans | $263 |
| Molina Mcaid | Molina Mcaid | $269 |
| Aetna Better Hlth Mcaid | Aetna Better Hlth Mcaid | $279 |
| Meridian Dnsp | Meridian Dnsp | $393 |
| Cigna One Health | Cigna One Health | $425 |
| Cigna Exch Ifp | Cigna Exch Ifp | $449 |
| Cigna Comm - All Other Plans | Cigna Comm - All Other Plans | $852 |
| UHC Core/Navigate 10/1/24 | UHC Core/Navigate 10/1/24 | $898 |
| UHC Core/Navigate/Nexus/Charter | UHC Core/Navigate/Nexus/Charter | $936 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $1,040 |
| Aetna Comm - All Other Plans | Aetna Comm - All Other Plans | $1,133 |
| BCBS Exch/Bce | BCBS Exch/Bce | $2,321 |
| Aetna Preferred | Aetna Preferred | $2,593 |
| BCBS Bco/Bcs | BCBS Bco/Bcs | $3,121 |
| BCBS PPO - All Other Plans | BCBS PPO - All Other Plans | $3,681 |
| BCBS HMO Ip/Op Only | BCBS HMO Ip/Op Only | $5,601 |
| Aetna Mcr Adv | Aetna Mcr Adv | $8,002 |
| BCBS Mcr Adv | BCBS Mcr Adv | $8,002 |
| Cigna Mcr Adv | Cigna Mcr Adv | $8,002 |
| Humana Mcr Adv - All Other Plans | Humana Mcr Adv - All Other Plans | $8,002 |
| Wellcare Mcr Adv - All Plans | Wellcare Mcr Adv - All Plans | $8,002 |
| Devoted Mcr Adv - All Plans | Devoted Mcr Adv - All Plans | $8,002 |
| UHC Mcr Adv | UHC Mcr Adv | $8,002 |
| Aetna Fide Snp | Aetna Fide Snp | $8,242 |
| Molina Fide-Snp | Molina Fide-Snp | $8,322 |
| Zing Health Mcr Adv - All Plans | Zing Health Mcr Adv - All Plans | $8,482 |
| UHC Exch | UHC Exch | $10,403 |
| Molina Exch - All Other Plans | Molina Exch - All Other Plans | $10,883 |
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