CT abdomen and pelvis with contrast at Southwest Medical Center. CPT 74177.
What Southwest Medical Center publishes for this service, straight from its standard-charges file, last updated July 22, 2026.
Outpatient / ER
$167cash price (self-pay)
$2,993list price
$151–$5,372range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Multiplan_phcs_medical_assistance_program_plan | Medicaid | $153 |
| Sunflower_ks_medicaid_plan | Medicaid | $154 |
| United_healthcare_medicaid__plan | Medicaid | $154 |
| Aetna_medicaid_plan | Medicaid | $157 |
| Multiplan_phcs_medicaid_plan | Medicaid | $157 |
| United_healthcare_medicare_plan | Medicare | $321 |
| Blue_cross_blue_shield_kansas_plan | Commercial | $480 |
| Coventry_aetna_plan | Commercial | $675 |
| National_beef_packing_plan | Commercial | $2,837 |
| Health_choice_plan | Commercial | $4,043 |
| Wppa_plan | Commercial | $4,043 |
| Multiplan_phcs_primary_network_plan | Commercial | $4,910 |
| United_healthcare_commercial_plan | Commercial | $5,025 |
| Multiplan_phcs_auto_plan | Commercial | $5,198 |
| Omni_network_plan | Commercial | $5,198 |
| Multiplan_phcs_complementary_network_plan | Commercial | $5,372 |
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