CT abdomen and pelvis with contrast at Gottlieb Memorial Hospital. CPT 74177.
What Gottlieb Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$1,101cash price (self-pay)
$5,795list price
$316–$4,230range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian | Medicaid | $316 |
| Molina | Medicaid | $316 |
| BCBS IL | MMP/Duals | $346 |
| Aetna | Medicare Advantage | $372 |
| VACCN United | Veterans Affairs | $372 |
| Humana | Medicare Advantage | $381 |
| Cigna | Medicare Advantage | $383 |
| Centene | Medicare Advantage | $391 |
| Molina | Medicare Advantage | $391 |
| Wellcare | Medicare Advantage | $391 |
| Oscar IFP | Health Exchange | $410 |
| Meridian | MMP/Duals | $432 |
| Molina Marketplace IFP | Health Exchange | $465 |
| Cigna | HMO | $519 |
| UHC | Navigate Core | $1,065 |
| UHC | All Products | $1,161 |
| Cigna | PPO | $1,170 |
| Humana | All Products | $1,206 |
| Aetna | All Products | $2,544 |
| BCBS IL | Blue Choice | $2,677 |
| BCBS IL | PPO | $3,332 |
| BCBS IL | HMO | $3,883 |
| BCBS IL | Blue Precision | $4,033 |
| Aetna | FH-Medical Rental | $4,230 |
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