CT abdomen and pelvis with contrast at Henry Ford Madison Heights Hospital. CPT 74177.
What Henry Ford Madison Heights Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$183–$829range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Meridian Health Plan | 1945_medicaid Replacement Meridian Health Outpa | $183 |
| Ahlic | 2163_ahlic 20241001 | $241 |
| Hap HMO | 2166_health Alliance HMO 20241001 | $241 |
| Hap HMO | 2174_sjma Health Alliance HMO 20241001 | $241 |
| Hap Preferred | 2171_hap Preferred (Php) 20241001 | $241 |
| Priority HMO | 2010_priority HMO 20210701 | $258 |
| Phcs POS | 1311_phcs POS 20201001 | $829 |
| Phcs PPO | 1457_phcs PPO 20201001 | $829 |
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