CT abdomen and pelvis with contrast at Beacon Kalamazoo. CPT 74177.
What Beacon Kalamazoo publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$189–$1,192range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| - None - | 3797_bomc, Bphc Humana Medicaid Outpatient 20250701 | $189 |
| Aetna Medicaid | 3788_bomc Medicaid Replacement Aetna Better Health Ou | $189 |
| Blue Caid | 3789_bomc Medicaid Replacement Blue Caid Complete Outpatie | $189 |
| Coventry Cares | 3790_bomc Medicaid Replacement Coventry Cares Outpati | $189 |
| Medicaid | 3798_bomc, Bphc Medicaid Outpatient 20250701 | $189 |
| Medicaid HMO | 3791_bomc Medicaid Replacement HMO Outpatient 20250701 | $189 |
| Meridian Medicaid | 3792_bomc Medicaid Replacement Meridian Outpatient | $189 |
| Mi Child | 3793_bomc Medicaid Replacement Michigan Child Outpatient 20 | $189 |
| Molina Medicaid | 3794_bomc Medicaid Replacement Molina Outpatient 202 | $189 |
| Priority Mcd | 3795_bomc Medicaid Replacement Priority Health Outpatie | $189 |
| UHC Mcd | 3796_bomc Medicaid Replacement United Health Care Community | $189 |
| Tricare | 3562_tricare Outpatient 20250101 | $332 |
| Cofinity Auto | 3697_bomc, Bphc Auto Mva 20250101 | $350 |
| Medicare Replacement | 3572_bomc, Bphc, Bogi, Bosu Medicare Advantage | $350 |
| St. Mary Transplant | 3576_bomc Mercy St. Mary Transplant 20250101 | $350 |
| Swmbh | 3546_bomc Sw Mi Behavioral Health Outpatient 20250101 | $350 |
| UHC Medicare | 3579_bomc Medicare Advantage United Health Care Outpati | $350 |
| UHC Medicare Adv 948 | 3578_bomc Medicare Advantage United Health Care | $350 |
| Veterans Administration | 3573_bomc, Bphc Veterans Administration Outp | $350 |
| Veterans Choice | 3575_bomc Veterans Choice Outpatient 20250101 | $350 |
| Aetna Mmai | 3581_bomc Medicare Advantage Aetna Mmai Outpatient 202501 | $357 |
| Meridian Mmai | 3580_bomc Medicare Advantage Meridian Mmai Outpatient | $367 |
| Molina Medicare | 3574_bomc, Bphc Medicare Advantage Molina Outpatient | $367 |
| Amish Medicare | 3756_bomc Amish Medicare Outpatient 20241001 | $402 |
| Smarthealth | 3547_bomc Smarthealth Op 20250101 | $490 |
| Smarthealth Bh Emp | 3548_bomc Smarthealth Bh Emp Op 20250101 | $490 |
| Bcn All Other | 3015_bomc Blue Cross Blue Shield Bcn 20220401 | $497 |
| Bomc Blue Cross Blue Shield Hpn 20241101 | 3644_bomc Blue Cross Blue S | $538 |
| BCBS All Other | 3643_bomc Blue Cross Blue Shield HMO-PPO 20241101 | $577 |
| Bcn 084 | 3646_bomc Blue Cross Blue Shield Bcn 084 20241101 | $577 |
Inpatient
—cash price (self-pay)
—list price
$189–$490range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cofinity Auto | 3850_bomc, Bphc Auto Mva 20251001 | $350 |
| Fidelis | 3836_bomc Medicare Advantage Fidelis Securecare Inpatient 20 | $350 |
| Medicare Replacement | 3837_bomc Medicare Advantage HMO Inpatient 2025 | $350 |
| Tricare | 2788_bomc, Bphc Tricare Inpatient 20211001 | $350 |
| UHC Medicare | 3840_bomc Medicare Advantage United Health Care Inpatie | $350 |
| UHC Medicare Adv 948 | 3841_bomc Medicare Advantage United Health Care | $350 |
| Veterans Choice | 2789_bomc Veterans Choice Inpatient 20211001 | $350 |
| Aetna Mmai | 3835_bomc Medicare Advantage Aetna Mmai Inpatient 2025100 | $357 |
| Meridian Mmai | 3838_bomc Medicare Advantage Meridian Mmai Inpatient 2 | $367 |
| Molina Medicare | 3842_bomc Medicare Advantage Molina Inpatient 202510 | $367 |
| Amish Medicare | 3853_bomc Amish Medicare Inpatient 20251001 | $402 |
| Smarthealth | 3852_bomc Smarthealth Ip 20251001 | $490 |
| Smarthealth Bh Emp | 3851_bomc Smarthealth Bh Emp Ip 20251001 | $490 |
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