CT abdomen and pelvis with contrast at Coffeyville Regional Medical Center. CPT 74177.
What Coffeyville Regional Medical Center publishes for this service, straight from its standard-charges file, last updated June 4, 2026.
Outpatient / ER
$1,472cash price (self-pay)
$2,103list price
$252–$2,103range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Caresource Kansas QHP | Medicaid Advantage | $252 |
| BCBS Kansas | Medicaid Advantage | $252 |
| Sunflower State Health Plan | Medicaid | $252 |
| Oklahoma Complete Health | Medicaid Advantage | $252 |
| Aetna Better Health Administrators, LLC | Medicaid Advantage | $254 |
| Humana | Medicare Advantage | $353 |
| Coventry | Medicare Advantage | $356 |
| Caresource Kansas QHP | Medicare Advantage | $356 |
| TriWest | Champus | $356 |
| United Healthcare | Commercial | $356 |
| Optum Care Network � Kansas City | Medicare Advantage | $392 |
| Aetna Network Services, LLC | Medicaid Advantage | $673 |
| Humana | Commercial | $1,262 |
| BCBS Kansas | Commercial | $1,514 |
| Health Partners of Kansas | Commercial | $1,893 |
| Montgomery County | Commercial | $2,103 |
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