CT abdomen and pelvis with contrast at Goshen Hospital. CPT 74177.
What Goshen Hospital publishes for this service, straight from its standard-charges file, last updated August 14, 2026.
Outpatient / ER
$2,797cash price (self-pay)
$3,996list price
$426–$1,168range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Advantage_Health_Solutions | MCRAHS | $426 |
| Aetna_Better_Health_of_IL | MCRAETIL | $426 |
| Aetna_Better_Health_of_Ohio | MCRAETBE | $426 |
| Argent_Medicare | ARGMCR | $426 |
| Atrio_Health_Plans | MCRATRIO | $426 |
| Avmed_Medicare_Choice | MCRAVMED | $426 |
| BC_Federal_Employee | BCFEDEE | $426 |
| BC_MCR_Advantage_PPO | MCRADV | $426 |
| Blue_Cross_Medicare_HMO | BCMCRHMO | $426 |
| Buckeye_Health_Plan | MCRBUCK | $426 |
| Coventry_Health_and_Life | MCRCOV | $426 |
| Emblem_Health | MCREMBLEM | $426 |
| Freedom_Healthcare | MCRFH | $426 |
| Geisinger_Health_Plan | MCRGEIHP | $426 |
| Health_First | MCRHF | $426 |
| Healthspring | MCRHS | $426 |
| Humana_Gold_Choice | HGC | $426 |
| Humana_Gold_Plus_HMO | MCRHUMHM | $426 |
| Humana_Group_Medicare_PFFS | MCRHGM | $426 |
| IEHP_Empire_Health_Plan | MCRIEHP | $426 |
| Independent_Care_Health_Plan | MCRINDCA | $426 |
| Kaiser_Permanente | MCRKP | $426 |
| MCR_Advantra_Freedom | MCRADVFR | $426 |
| MCR_Allwell_MHS | MCRALLWE | $426 |
| MCR_Banner_Health | MCRBANNER | $426 |
| MCR_Cigna_Healthspring | MCRCIGHS | $426 |
| MCR_Complete | MCRC | $426 |
| MCR_Complete_PPO | MCRCPPO | $426 |
| ChampVA | CHAMPVA | $439 |
| Ambetter_MHS_Marketplace | MKTMHS | $614 |
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