CT abdomen and pelvis with contrast at Bronson South Haven Hospital. CPT 74177.
What Bronson South Haven Hospital publishes for this service, straight from its standard-charges file, last updated August 3, 2026.
Outpatient / ER
$155cash price (self-pay)
$3,784list price
$146–$3,784range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Priority Health | Choice Medicaid | $182 |
| PHP | Medicaid | $186 |
| BCBS | Complete | $191 |
| Meridian | Medicaid | $191 |
| Aetna | Medicare | $314 |
| BCBS | Mappo | $314 |
| BCN | Medicare Advantage | $314 |
| Health Alliance Plan | Medicare Advantage | $314 |
| Pace | Swmi | $314 |
| PHP | Medicare Advantage | $314 |
| Priority Health | Medicare | $314 |
| Railroad Medicare | Medicare | $314 |
| Uhccp | Dnsp | $314 |
| UHC | Dual Complete DSNP/Medicare Advantage | $314 |
| Meridian | Complete - MI Health Link - DSNP/Wellcare - Medicare Advant | $330 |
| PACE | Medicare | $330 |
| Molina | Medicare/Medicaid | $345 |
| Humana | Choice PPO Medicare | $348 |
| Mclaren | Medicaid | $348 |
| Mclaren | Medicare | $348 |
| PHP | Commercial | $382 |
| MI Amish Medical Board | Commercial | $400 |
| Cofinity | Commercial | $404 |
| Allen County Amish Medical Aid | Commercial | $435 |
| Amish Plain Church Group | Commercial | $435 |
| UHC | Exchange | $500 |
| Priority Health | Narrow Network | $1,053 |
| Priority Health | Cigna Priority Health/HMO/PPO/Tiered Network | $1,258 |
| Opus (Opus Packaging Group) | HMA | $1,492 |
| Nomi Health | Commercial | $1,720 |
Inpatient
$3,027cash price (self-pay)
$3,784list price
$2,838–$3,784range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Opus (Opus Packaging Group) | HMA | $2,838 |
| Encore Health Key Benefits | Commercial | $3,027 |
| Nomi Health | Commercial | $3,103 |
| BCBS | Trust/PPO | $3,107 |
| BCN | Commercial | $3,107 |
| Multiplan/Beech St/PHCS | Commercial | $3,216 |
| UHC | All Payor (Choice/PPO) + Core | $3,330 |
| Aetna | Commercial | $3,405 |
| Mclaren | Commercial | $3,405 |
| Cofinity | Commercial | $3,557 |
| Asr | Asr | $3,670 |
| Healthscope | Commercial | $3,670 |
| Healthscope | Whirlpool | $3,784 |
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