CT abdomen and pelvis with contrast at Providence Medical Center. CPT 74177.
What Providence Medical Center publishes for this service, straight from its standard-charges file, last updated March 17, 2026.
Outpatient / ER
$328cash price (self-pay)
$5,196list price
$154–$4,801range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Aetna Medicaid Adjusted Rate | $154 |
| Traditional Medicaid | Traditional Medicaid | $207 |
| UHC | UHC Medicaid | $313 |
| Celtic | Celtic Medicaid | $319 |
| Healthy Blue | Healthy Blue Medicaid (01/01/2025 to 12/31/2026) | $319 |
| COMP ALLIANCE - FKA COMPRESULTS Worker Compensation | COMP ALLIANCE - | $324 |
| Midland Care Connection | Midland Care Connection | $329 |
| Traditional Medicare | Traditional Medicare | $329 |
| Tricare | Tricare | $329 |
| UHC | UHC Medicare | $329 |
| UHC | UHC Va Ccn | $329 |
| Aetna | Aetna Medicare | $329 |
| Cigna | Cigna Healthspring | $329 |
| Health Net Federal Services - Tricare | Health Net Federal Services - | $329 |
| Celtic | Celtic Medicare | $345 |
| Healthy Blue | Healthy Blue Medicare | $345 |
| Kansas Superior Select | Kansas Superior Select | $345 |
| OHA Networks | OHA NETWORKS WC | $349 |
| Worker Compensation | Worker Compensation | $360 |
| Corizon | Corizon | $427 |
| Celtic | Home State Health Plan Ins Exchange | $444 |
| UHC | UHC Commercial Exchange | $460 |
| Well Path Prison | Well Path Prison | $460 |
| Employer Direct Healthcare | Employer Direct Healthcare Commercial | $460 |
| Centurion | Centurion | $493 |
| Naphcare | Naphcare | $509 |
| BCBS | BCBS Exchange | $526 |
| Celtic | Celtic Ins Exchange | $526 |
| Aetna | Aetna Commercial | $555 |
| BCBS | BCBS Select | $608 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.