CT abdomen and pelvis with contrast at King's Daughters Medical Center. CPT 74177.
What King's Daughters Medical Center publishes for this service, straight from its standard-charges file, last updated September 25, 2026.
Outpatient / ER
$2,326cash price (self-pay)
$5,815list price
$249–$5,234range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthsmart | Commercial | $249 |
| Molina | Exchange | $365 |
| Buckeye Community Health Plan | Exchange | $415 |
| Blue Cross Blue Shield | HMO | $562 |
| Caresource | Exchange | $614 |
| Blue Cross Blue Shield | PPO | $677 |
| United Healthcare Commercial/Behavioral Health | Commercial | $3,611 |
| Aetna | Commercial | $4,297 |
| The Health Plan | Commercial | $4,652 |
| Multiplan | Commercial | $5,234 |
Inpatient
$2,326cash price (self-pay)
$5,815list price
$2,714–$5,234range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Blue Shield | HMO | $2,714 |
| Blue Cross Blue Shield | PPO | $3,270 |
| Aetna | Commercial | $4,297 |
| The Health Plan | Commercial | $4,652 |
| Multiplan | Commercial | $5,234 |
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