CT abdomen and pelvis with contrast at Breckinridge Memorial Hospital. CPT 74177.
What Breckinridge Memorial Hospital publishes for this service, straight from its standard-charges file, last updated July 16, 2026.
Outpatient / ER
$1,636cash price (self-pay)
$3,271list price
$200–$3,271range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| University Health Care - All Other Plans | University Health Care - Al | $200 |
| Wellcare Mcaid - All Other Plans | Wellcare Mcaid - All Other Plans | $297 |
| Aetna Better Health Medicaid | Aetna Better Health Medicaid | $297 |
| Blue Cross Medicaid | Blue Cross Medicaid | $297 |
| Blue Cross Pathway Hpn | Blue Cross Pathway Hpn | $711 |
| Blue Cross Pathway HMO | Blue Cross Pathway HMO | $711 |
| Blue Cross PPO - All Other Plans | Blue Cross PPO - All Other Plans | $827 |
| Blue Cross HMO | Blue Cross HMO | $827 |
| Blue Cross Trad | Blue Cross Trad | $827 |
| Tricare - All Plans | Tricare - All Plans | $1,060 |
| Molina Mcr Adv - All Plans | Molina Mcr Adv - All Plans | $1,132 |
| UHC Mcr Adv | UHC Mcr Adv | $1,178 |
| UHC Va Ccn | UHC Va Ccn | $1,178 |
| Aetna Mcr Adv | Aetna Mcr Adv | $1,178 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $1,178 |
| Caresource - All Plans | Caresource - All Plans | $1,178 |
| University Health Care Mcr Adv | University Health Care Mcr Adv | $1,178 |
| Wellcare Mcr Adv | Wellcare Mcr Adv | $1,178 |
| Ambetter Comm/Exch - All Plans | Ambetter Comm/Exch - All Plans | $1,295 |
| Aetna Commercial - All Other Plans | Aetna Commercial - All Other Plan | $2,453 |
| UHC Comm - All Other Plans | UHC Comm - All Other Plans | $2,780 |
| Blue Cross Mcare Select | Blue Cross Mcare Select | $3,271 |
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