CT abdomen and pelvis with contrast at HSHS Holy Family Hospital. CPT 74177.
What HSHS Holy Family Hospital publishes for this service, straight from its standard-charges file, last updated March 24, 2026.
Outpatient / ER
$4,668cash price (self-pay)
$6,483list price
$138–$6,483range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Healthcare | Molina Medicaid | $277 |
| Meridian Health Plan | Meridian HMO Mcd | $290 |
| Aetna | Aetna Medicare | $374 |
| Blue Cross Blue Shield Of Illinois | BCBS IL Medicare | $374 |
| Blue Cross Blue Shield Of Illinois | BCBS IL Mmai | $374 |
| Blue Cross Blue Shield Of Illinois | Blue Cross Blue Shield Of Illinoi | $374 |
| Clear Spring Health Of Illinois | Clear Spring Health Medicare Adv | $374 |
| Humana | Humana Medicare | $374 |
| Humana | Humana Medicare Advantage | $374 |
| Live360 | Live360 Medicare Cost Plan | $374 |
| United Healthcare | United Health Care Medicare | $374 |
| Molina Healthcare | Molina Medicare | $393 |
| Naphcare | All Commerical Naphcare | $804 |
| Celtic Insurance Company | All Commercial Exchange Ambetter | $822 |
| Claim Doc | All Commercial Claim Doc | $935 |
| Hopetrust | All Commercial Hopetrust | $935 |
| United Healthcare | All Commercial United Healthcare | $1,315 |
| Amish Community | Amish Community Discount | $1,815 |
| Amish Community | Plain Church Medical Group | $1,815 |
| Cigna | All Commercial Cigna | $2,290 |
| Wellfirst | All Commercial Wellfirst | $4,167 |
| Aetna | All Commercial Aetna | $4,551 |
| First Health | All Commercial First Health Network | $4,804 |
| Healthlink | All Commercial Healthlink | $4,888 |
| Healthlink | All Commercial Healthlink - PPO | $4,888 |
| Healthlink | Healthlink Casino Queen | $4,888 |
| Cofinity | Cofinity | $5,511 |
| Multiplan/Phcs | All Commercial Multiplan | $5,511 |
| Consociate Group | All Commercial Consociate Group | $5,835 |
| Provider Network Of America | All Commercial Provider Network Of Ameri | $5,835 |
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