CT abdomen and pelvis with contrast at Tj Health Samson Community Hospital. CPT 74177.
What Tj Health Samson Community Hospital publishes for this service, straight from its standard-charges file, last updated April 23, 2026.
Outpatient / ER
$140cash price (self-pay)
$3,937list price
$0.01–$3,740range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wellcare Mcr Adv - All Other Plans | Wellcare Mcr Adv - All Other Plan | $218 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $218 |
| Signature Health - All Plans | Signature Health - All Plans | $220 |
| Humana Mcr Adv - All Other Plans | Humana Mcr Adv - All Other Plans | $220 |
| Molina Mcr Adv | Molina Mcr Adv | $222 |
| Devoted Mcr Adv - All Plans | Devoted Mcr Adv - All Plans | $229 |
| Aetna Better Health Mcaid - All Plans | Aetna Better Health Mcaid - Al | $257 |
| Humana Mcaid | Humana Mcaid | $257 |
| Molina Mcaid | Molina Mcaid | $264 |
| Wellcare Mcaid | Wellcare Mcaid | $282 |
| Caresource - All Plans | Caresource - All Plans | $319 |
| Molina Marketplace - All Other Plans | Molina Marketplace - All Other | $319 |
| Blue Cross Path HMO | Blue Cross Path HMO | $340 |
| Blue Cross Path Hpn/PPO | Blue Cross Path Hpn/PPO | $765 |
| Blue Cross HMO | Blue Cross HMO | $850 |
| Blue Cross PPO | Blue Cross PPO | $850 |
| Blue Cross Trad - All Other Plans | Blue Cross Trad - All Other Plans | $850 |
| UHC All Payer - All Plans | UHC All Payer - All Plans | $1,530 |
| Center Care Select - All Plans | Center Care Select - All Plans | $1,714 |
| Blue Cross Mcr Select | Blue Cross Mcr Select | $1,714 |
| Phcs/Multiplan - All Plans | Phcs/Multiplan - All Plans | $3,701 |
| First Health - All Plans | First Health - All Plans | $3,740 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.