CT abdomen and pelvis with contrast at Covenant HealthCare. CPT 74177.
What Covenant HealthCare publishes for this service, straight from its standard-charges file, last updated May 15, 2026.
Outpatient / ER
$260cash price (self-pay)
$2,597list price
$82.48–$4,339range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Healthy Michigan Blue Cross Complete | Managed Medicaid | $192 |
| Healthy Michigan McLaren | Managed Medicaid | $192 |
| Healthy Michigan Meridian | Managed Medicaid | $192 |
| Healthy Michigan Molina | Managed Medicaid | $192 |
| Healthy Michigan Priority Health | Managed Medicaid | $192 |
| Aetna | Medicare Advantage | $239 |
| Health Alliance Plan of Michigan | Medicare Advantage | $239 |
| Humana | PPO Medicare Advantage | $239 |
| McLaren Advantage | Medicare Advantage | $239 |
| Molina Healthplan | Medicare Advantage | $239 |
| Physicians Health Plan Advantage/Advantage Plus | HMO Medicare Advanta | $239 |
| Priority Health | Medicare Advantage | $239 |
| Health Alliance Plan of Michigan | HMO | $251 |
| Health Alliance Plan of Michigan | PPO | $251 |
| Blue Care Network | Medicare Advantage | $354 |
| McLaren Health Advantage | Commercial | $356 |
| Blue Care Network | Commercial | $394 |
| Blue Cross Anthem | Commercial | $394 |
| Blue Cross Blue Shield Traditional | Commercial | $394 |
| Blue Cross Trust | Commercial | $394 |
| Aetna/Aetna Select | Commercial | $413 |
| Priority Health E | Commercial | $1,194 |
| Health Advantage McLaren Employee | Commercial | $1,409 |
| Priority Health | PPO | $1,428 |
| Physicians Health Plan | Commercial | $1,428 |
| Humana | Commercial | $1,947 |
| Meritain Health | Commercial | $1,986 |
| Multiplan | Commercial | $2,337 |
| Cigna | Commercial | $2,652 |
Inpatient
$3,375cash price (self-pay)
$4,821list price
$2,169–$4,339range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| McLaren Health Advantage | Commercial | $2,169 |
| Priority Health E | Commercial | $2,218 |
| Cigna | Commercial | $2,652 |
| Health Advantage McLaren Employee | Commercial | $2,652 |
| Physicians Health Plan | Commercial | $2,652 |
| Priority Health | PPO | $2,652 |
| Aetna/Aetna Select | Commercial | $3,543 |
| Humana | Commercial | $3,616 |
| Meritain Health | Commercial | $3,688 |
| Multiplan | Commercial | $4,339 |
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