CT abdomen and pelvis with contrast at Holland Hospital. CPT 74177.
What Holland Hospital publishes for this service, straight from its standard-charges file, last updated September 21, 2026.
Outpatient / ER
$1,676cash price (self-pay)
$2,793list price
$330–$5,726range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Life Circles-All Plans | Life Circles-All Plans | $330 |
| Health Alliance Mcr Adv | Health Alliance Mcr Adv | $348 |
| Ph Mcr Adv | Ph Mcr Adv | $348 |
| Va Ccn - All Plans | Va Ccn - All Plans | $348 |
| Aetna Mcr Adv | Aetna Mcr Adv | $358 |
| Longevity Health Plan-All Plans | Longevity Health Plan-All Plans | $375 |
| Aetna Existing Bus - All Other Plans | Aetna Existing Bus - All Other | $401 |
| Aetna New Bus | Aetna New Bus | $401 |
| Cofinity -All Plans | Cofinity -All Plans | $534 |
| BCBS - All Plans | BCBS - All Plans | $555 |
| Cigna - All Plans | Cigna - All Plans | $691 |
| Sisco-All Other Plans | Sisco-All Other Plans | $759 |
| Sisco Epi | Sisco Epi | $759 |
| Priority Health - All Other Plans | Priority Health - All Other Plans | $766 |
| Health Alliance HMO | Health Alliance HMO | $788 |
| Health Alliance Ahl - All Other Plans | Health Alliance Ahl - All Othe | $824 |
| Asr - All Plans | Asr - All Plans | $824 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $894 |
| Ph Mcaid | Ph Mcaid | $894 |
| Multiplan - All Plans | Multiplan - All Plans | $2,430 |
| Benefit Source Inc-All Plans | Benefit Source Inc-All Plans | $2,514 |
| First Health-All Plans | First Health-All Plans | $2,514 |
| Usa Managed Care-All Plans | Usa Managed Care-All Plans | $2,514 |
| Integrated Health Plans-All Plans | Integrated Health Plans-All Plans | $2,653 |
| UHC Mcr Adv | UHC Mcr Adv | $2,793 |
| UHC Mcaid | UHC Mcaid | $2,793 |
| Nomi Health - All Plans | Nomi Health - All Plans | $5,726 |
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