CT abdomen and pelvis with contrast at SBL Fayette County Hospital. CPT 74177.
What SBL Fayette County Hospital publishes for this service, straight from its standard-charges file, last updated June 12, 2026.
Outpatient / ER
$497cash price (self-pay)
$6,708list price
$84.07–$5,702range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Better Health | Aetna Better Health | $382 |
| Meridian-All Plans | Meridian-All Plans | $382 |
| Blue Cross Community Care-All Plans | Blue Cross Community Care-All Pl | $382 |
| Health Alliance Medicaid | Health Alliance Medicaid | $382 |
| Illinicare - All Plans | Illinicare - All Plans | $382 |
| Molina Medicaid-All Plans | Molina Medicaid-All Plans | $382 |
| Health Alliance Mcare | Health Alliance Mcare | $1,115 |
| Healthlink Mcr Adv | Healthlink Mcr Adv | $1,115 |
| Humana Choicecare - All Plans | Humana Choicecare - All Plans | $2,147 |
| Coventry/Ghp-All Plans | Coventry/Ghp-All Plans | $2,237 |
| Aetna Health Inc - All Other Plans | Aetna Health Inc - All Other Plan | $2,260 |
| Aetna Coventry | Aetna Coventry | $2,371 |
| Healthlink HMO | Healthlink HMO | $2,562 |
| Cigna - All Plans | Cigna - All Plans | $2,564 |
| Health Alliance - All Other Plans | Health Alliance - All Other Plans | $2,854 |
| Healthlink PPO - All Other Plans | Healthlink PPO - All Other Plans | $2,897 |
| BCBS Illinois - All Plans | BCBS Illinois - All Plans | $2,918 |
| Multiplan - All Plans | Multiplan - All Plans | $2,929 |
| United Healthcare - All Plans | United Healthcare - All Plans | $2,990 |
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